Yitzhar settlers as 'errant weeds'

Young woman who supports assaulting and even killing IDF soldiers is not just 'one of a few psychos,' as those downplaying the issue claim. Because one young woman from YItzhar settlement – a "girl," as Bayit Yehudi Knesset Member Orit Strock referred to her in an attempt to sugar the pill – wrote that a person should not fill his mouth with laughter in this world, then we shall go against our basic human tendency, and not fill our mouths with laughter. We won't hold our peace either, and the truth is that we will also seriously restrain ourselves and not fill our mouths with the things that should be said about her and her friends, the people of Yitzhar, the capital of defilement created by settlement in the territories. And all we will say, with a lot of restraint, is what ultimately must be said under these circumstances. First of all, these are not "errant weeds," as those downplaying the issue try to claim. They have not been weeds for a long time now, and long before this odd email correspondence revealed by Yedioth Ahronoth reporter Akiva Novick, which discussed the question of whether shooting a soldier during an evacuation is permitted, and that was after it was agreed that throwing stones at him is not only permitted but even welcome. And it's not only welcome, but it has even been happening in practice for some time now. These are not weeds, and whatever they may be, they are not new in this rotten garden. Soldiers who serve in this region, some of whom are in charge of the community's security, say that the slashing of the tires of Samaria Brigade Commander Colonel Yoav Yarom's jeep, as well as the incident in which Yitzhar "heroes" stormed the IDF compound set up there, are part of an ongoing episode of Jewish terror focusing not only on Palestinians in the nearby communities, as part of what they define as "price tag" activities, but also on members of the security forces, police and IDF as one. "You never know if a patrol in the community and its surroundings won't end with a barrage of stones," says a reserve officer who served there. "And the most irritating thing is that later on in the army, and in the community, they'll feed you with the Shabbat cakes they bring and tell you to let it be, because it's just a few psychos." They're not psychos, he says, and the proud mother of the righteous Eliraz Fein, who saw no halachic problem in killing a soldier during a night-time evacuation, doesn't think her daughter is a psycho either. "The young generation has had enough of walking around low-spirited and frightened," she explained Wednesday. And if that were not enough, she even clarified exactly what the young generation has had enough of: "That Jewish women cannot walk around freely like Arab women." And if that sounds familiar, with a small reversal of roles, it's only because we just marked 70 years since the Holocaust that took refuge in the shadow of similar texts. And yet all this – irritating, repulsive, threatening and troublesome as it may be – is not as serious as the helplessness demonstrated by those who are supposed to handle such phenomena - the price tag in its different forms, the assaults on the security forces and the open incitement. Starting with the police, through the Shin Bet, to the army. One doesn’t have to study hard to understand just how long the General Security Services' (Shin Bet) arm is. It's just a matter of deciding. Deciding that we've had enough, really; that it's time to deal with this phemomenon the way the State of Israel knows how to do. That there is no justification for this unfounded tolerance, especially not with quite a few of the Yesha Council leaders already confessing to impotence and asking for help. This phenomenon is only part of the image of this state, even if it does take place beyond the Green Line. It is not something done under compulsion that cannot be condemned; it is not a predestination that cannot be changed. It should be dealt with, and if this text had been written many years ago, it could end with the sentence "the sooner the better." But in the spirit of these days, this text will end with a question: Just what kind of parents, whoever and wherever they are, agree that their sons will be the next Dvvid the Nahal soldier on the one hand – yes, even after the completely irrelevant explanations provided by the army that were meant to explain why he was sent to prison – and just what kind of parents, whoever and wherever they are, agree on the other hand that Eliraz from Yitzhar will lead the campaign of revenge against those soldiers?

The Right of Return isn't available to sex offenders ( that goodness)

Israel likely to deport British Jewish pedophile

After High Court of Justice denies Israeli citizenship to Todros Grynhaus, District Court paves way for deportation.

Israel was expected to deport a suspected British Jewish pedophile following a Central District Court ruling that allows the state to deport rather than extradite suspected criminals who entered the country illegally, the Jewish Chronicle reported this week.
  
Todros Grynhaus, 48 from Salford, was charged with seven sexual assaults on children in Manchester.


He violated his bail conditions last year when he went on the run with his wife and children, fleeing Britain with a fake passport. He was arrested in February in Jerusalem after the British police issued an international warrant for his arrest.


Grynhaus hired two Israeli legal teams to fight his deportation by trying to gain Israeli citizenship under the Law of Return, or otherwise seeking to settle in countries that don't have extradition agreements with the UK. 


Israeli law only allows formal extradition of foreign criminals, a process that could take up to two years and risk the possibility that Grynhaus could be released from prison during the proceedings.


Grynhaus's lawyers tried to force Britain to use complicated extradition powers rather than allow Israel to deport him back to England, to draw out the proceedings against him.


But District Court Judge Dana Marshak-Marom ruled that Grynhaus's "failed efforts" to avoid being returned to the United Kingdom strengthens Israel's legal authority to deport him and other suspected foreign criminals.


Late last year, the High Court of Justice issued a landmark ruling denying Grynhaus an Israeli citizenship and with that banning other Jewish sex offenders of using the Law of Return to gain citizenship.


"Without such (legal) interpretation it would encourage criminals from across the world to use Israel as a place of refuge as (Grynhaus) has attempted to do," Marshak-Marom, who commended the High Court's ruling, was quoted by the Jewish Chronicle as saying.

Grynhaus, however, will be able to make one final appeal before a final decision could be made on his deportation.

He was set to stand trial in Manchester upon his return to the UK.

Security, Privacy and the art of Discrimination

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Knesset ruling follows public outcry after improper treatment of an Arab Israeli teacher, who underwent a strip-search.

The Knesset Public Petitions Committee decided on Monday that Israeli Airport Authority officials will meet with people who have been forced into invasive security checks. The meetings, which will involve Arab MKs will be part of an attempt to enlighten airport officials on the often humiliating security searches that Arabs have to go through.

AN EL AL plane at Ben Gurion International Airport – Photo Courtesy: Wikimedia Commons

Haaretz newspaper reported that the decision follows last month’s public outcry over the treatment of Knesset Public Petitions Committee and Arab Israeli teacher who was strip-searched while flying with her Jewish students.

MK Adi Kol, chairperson of the Public Petitions Committee, said about the decision, “The possibility of meeting a person who has undergone the process is likely to engender basic sensitivity that would prevent such incidents in the future.”

Haaretz reported that the airport authority’s legal adviser Aryeh Shaham adopted the committee’s recommendation. However, he made a point of saying that the airport does not engage in any type of racial profiling.

Ben Gurion Int’l Airport on the outskirts of Tel Aviv, July 25, 2007 – Photo: Jack Guez -AFP/File

“The procedures aren’t different for this or that person, and the check isn’t based on population group,” Shaham said. He also criticized Israel’s Supreme Court of creating difficulties for the airports authority with their “strict supervision.”

Shaham also noted that “from a statistical point of view, barely 5 percent of minorities are checked.” He also claims that of the 50 complaints filed last year against the Eilat Airport, where Shehadeh was strip-searched, only 9 of them were brought by Arabs.

Yet Arab MKs are adamant that Arabs are treated differently in airport security checks.

“Instances of humiliation are the rule and instances in which there is no humiliation are the exception,” Balad MK Jamal Zahalka said. Hadash MK Afou Agbaria also confirmed that he has in the past been forced to undergo humiliating security checks at Israel’s airports.

Air Port Security and Civil Rights in Zion

By Jonathan Danilowitz ( Guest Blogger)

The views expressed of Jonathan Danilowitz in this blog are not necessary those of Stephen Darori, a Rip Roaring Right Wing Zionist and never ever ashamed to admit so - Jonathan if you look like an Arab,Dress like an arab, Speak like like an Arab, Identify  with  in Hamas,Fatah,Hezbollah and dress your kids up as suicide bombers for Purim....you will be tagged as a potential one yourself and personally my policy with such explosive  people... is shoot first and if you made a mistake ... "whoops" is a great and acceptable excuse ( too) 

http://www.quora.com/Living-in-Israel/What-is-the-most-embedded-picture-in-your-mind-with-regard-to-terrorist-and-terror-attacks-in-Israel-What-is-it-like-to-live-through-an-attack-Please-add-pictures-where-ever-possible?share=1

Last week a local newspaper ran an article about an Arab woman (a teacher) who was searched and questioned (much more than other passengers, according to her) at an Israeli airport. The teacher was accompanying a group of students and was embarrassed, shamed, inconvenienced and “denied her civil rights”.

I have no doubt that she deserved better treatment. I have no doubt that the search was unpleasant and degrading, to say the least. I share her dismay.

I recall the last time I went through security at an American airport. I had to get to the airport 3 hours before my flight. I had to wait on line endlessly with all the other passengers going through security. We all had to remove our shoes, belts, jackets, hats. We all had to take out our laptops, cellphones and tablets. Many passengers had to give up bottles of perfume, cans of shaving cream, tubes of toothpaste; nail scissors, nail files, and the likes. Because I had an Israeli passport I was doubly scrutinized. The snail-like line was interminable. When I finally finished, I tried to make sure I had everything. I did, but I’ve heard hair-raising stories of lost everythings – from belts to wallets to cellphones. The crowds, the rush, the hurry to catch a flight – it’s a recipe for disaster.

I also recall when all this began. (Years ago one could arrive at the gate 10 minutes before a flight , check in there and zip onto the aircraft.) Arab terrorists began hijacking planes. So airlines hired in-flight security guards (guess who pays? You, the passenger.) Then things got worse so they started  airport security checks (yes, the cost is added to your flight ticket price). Finally 9/11 and all hell broke loose. Security staff, security equipment, endless hassles, delays and inconvenience – and again – the passengers pay, both in time and money.

It’s very sad. It does not diminish the unpleasantness of the teacher’s inconvenience, but it does help to remember the source of all the unpleasantness. She is not to blame. But airport security in Israel (and indeed, anywhere) exists to ensure that all passengers arrive at their destinations safely.

Even at greater inconvenience to some.

A ‘terrorist’ is no ‘enemy combatant’

The alleged Boston bomber is talking. So far, both what he’s saying and the fact he’s saying it underscore that the government made the right decision in charging him as a criminal in a U.S. federal court, rather than designating him an “enemy combatant” in military custody.

Dzhokhar Tsarnaev has been charged with using weapons of mass destruction, a charge that could land him the death penalty. He’s reportedly told investigators that he and his brother acted on their own, without any instructions from al Qaeda, and that the attack was motivated by a desire to “defend Islam.”

The strength of the evidence (he was caught on video laying his backpack down at the site of the bombing) and the severity of the potential penalty haven’t stopped critics of the Obama administration from claiming he should have been designated and detained as an enemy combatant, though. That’s because according to Senator Lindsey Graham (R-S.C.) the United States is engaged in a war that reaches from the highlands of Afghanistan to the streets of downtown Boston. Therefore we ought to be treating our self-proclaimed enemies accordingly.

Even if one could concoct a legal justification for treating Tsarnaev as an “enemy combatant,” as Graham and others insist is proper, as a practical matter it is a terrible idea.

There is no evidence so far suggesting Tsarnaev and his brother were working with al Qaeda, the Taliban or any of the “associated forces” that Washington says we’re at war with. So there’s no legal basis for treating him as an enemy combatant. That status is reserved for members of armed groups with which we’re actually at war. Proclaiming oneself at war with the United States based on some twisted ideology and imagined battleground doesn’t legally qualify.

What’s more, Tsarnaev is a U.S. citizen. Any attempt to detain him as an enemy combatant would face strong constitutional challenge.

Calling a 19-year-old American, who was allegedly inspired online to engage in militant jihad, an “enemy combatant” is precisely the wrong approach. It buys into his twisted and dangerous view that the United States is at war with all Muslims and that only by attacking Americans can he serve Allah.

This is an absurd belief, of course, unsupported by any rational reading of Islamic tenets. But charging Tsarnaev as an enemy combatant would lend credibility to his world view – elevating his status in a way that could be a lethal motivation for others.

Judge William Young, who sentenced the “shoe bomber,” Richard Reid, in 2002, faced similar pressures. His words still resonate: “You are not an enemy combatant,” he said to Reid in a Boston federal court. “You are a terrorist. You are not a soldier in any war. You are a terrorist. To give you that reference, to call you a soldier gives you far too much stature.”

Reid, like Tsarnaev, was a self-proclaimed enemy of the United States who said he tried to kill Americans in “allegiance to Islam.” To treat such men as enemy combatants is to confirm their view of a global religious war. And terrorists aren’t the only ones who hold that extremely dangerous view.

Consider what Tsarnaev’s mother said to a reporter on Tuesday. Zubeidt Tsarnaev, who lives in the Russian Republic of Dagestan, maintains her sons’ innocence and told CNN that she believes they were framed by U.S. authorities because they were Muslim. “They were being killed just because they were Muslim,” she said. “Nothing else.”

She’s surely not the only one who believes that.

Still, some lawmakers and commentators continue to insist that alleged terrorists like Tsarnaev should be treated as enemy combatants. The assumption seems to be that by denying them the rights afforded in the U.S. criminal justice system – namely, the rights to remain silent and to an attorney – will make them more likely to provide valuable information to U.S. authorities. “Naming him an enemy combatant would be useful,” the Wall Street Journal claimed, because the “designation allows for extensive, long-term interrogation without a lawyer.”

There is no support, however, for the claim that long-term interrogation without a lawyer helps anyone.

First, the FBI can invoke a “public safety exception” that allows agents to question a suspect about impending threats before reading him his rights. But after that initial questioning, accused terrorists usually continue to cooperate with authorities and provide valuable information – even after they’re told they can remain silent and have the assistance of counsel. Indeed, it’s often their lawyers who convince them to do that.

As David Kris, former head of the Justice Department’s National Security Division, explained after leaving office: “The reality is that when sophisticated defense attorneys determine that the government has strong, admissible evidence to support a conviction and lengthy sentence, they will often encourage their clients to cooperate. In this sense, defense lawyers can be very helpful.”

They know, Kris explained, that suspects charged with terrorism are almost always convicted and face long prison sentences. “This creates powerful incentives to work within the system – to cooperate and obtain a somewhat shorter sentence or improved conditions of confinement – rather than to challenge the system.”

This is what’s happened in recent major cases. Faisal Shahzad, the Times Square bombing suspect, for example, was initially questioned without a lawyer or Miranda warnings under the public safety exception and provided what the FBI called “valuable intelligence and evidence.” After he was read his rights, he continued to do more of the same.  Within a month, after explaining exactly where and from whom he’d received explosives training, he’d confessed to 10 felonies.

Najibullah Zazi, the Denver airport shuttle bus driver who confessed to leading a plot to attack the New York City subway system, also gave investigators valuable information about others involved in the plan, their training, motives and ties to an al Qaeda recruiter. So did the Detroit “underwear bomber” Umar Farouk Adbulmutallab – after he was advised of his right to remain silent and his right to an attorney.  The list goes on.

Indeed, since the September 11 terrorist attacks, federal law enforcement has successfully prosecuted nearly 500 terrorism-related cases, often based on information received from cooperating defendants. The military commissions prosecuting alleged enemy combatants in Guantanamo Bay, on the other hand, have completed only seven cases. Two of those convictions have been reversed on appeal.

The assumption that imprisoning a suspect indefinitely as an enemy combatant will prevent the next attack has no basis. Indeed, the United States continues to hold 166 prisoners at Guantanamo Bay. That didn’t prevent this attack. It may have inspired it. At the very least, it probably fueled the older brother’s suspicions that the U.S. government is at war with the Muslim world.

So far, Dzokhar has reportedly acknowledged his role in the bombings that killed three people and injured more than 250 others. He’s said that the brothers were operating on their own, without help from al Qaeda or any other overseas terrorist organizations. The FBI will certainly investigate those claims and see if any evidence suggests otherwise.

But now is the time to commend federal law enforcement for its handling of this case and to support its continued investigation. This is not the time to derail the case by diverting it to a system that has repeatedly failed elsewhere.

Critics should be careful what they wish for.

The Legalization of Marijuana

• 
  An emperor of China, Shen Nung, is held to be among the first to report on therapeutic uses of cannabis in a medicinal compendium that dates to 2737 BCE. In 1839, a British doctor working in India published a paper on cannabis as an analgesic and appetite stimulant that also tempered nausea, relaxed muscles, and might ameliorate epileptic seizures. His observations led to widespread medical use of cannabis in the United Kingdom; it was prescribed to Queen Victoria for relief of menstrual discomfort.”

Jeff Chiu/AP Images

Medical marijuana patient Kevin Brown at the Apothecarium, a medical cannabis dispensary in San Francisco, December 2011

In the summer of 2006, a young scientist from Israel joined my laboratory. He came to learn how viruses attack cells, a major focus of my research program. And I looked forward to drawing on his expertise in an emerging area of science that intrigued me: the biological effects of cannabinoids, the active chemical compounds in the marijuana plant. The Israeli researcher had trained at Jerusalem’s Hebrew University with Professor Raphael Mechoulam, a chemist credited with the discovery in 1964 of delta-9-tetrahydrocannabinol (THC), the primary psychoactive compound in marijuana. Mechoulam later characterized cannabidiol (CBD), a related substance plentiful in the plant, as distinct from THC in that it had no discernible effects on mood, perception, wakefulness, or appetite.1

The work of the young scientist proved productive. In short order, he tested the effects of several cannabinoids on a herpes virus that promotes the development of Kaposi’s sarcoma, a disfiguring and sometimes fatal tumor among people with impaired immunity, like those with AIDS. It turned out that CBD, the plentiful, nonpsychoactive compound, could switch off the malignant effects of the virus.2 Scientists in my department also found that cannabinoids could alter how white blood cells migrated in response to physiological stimuli, a key aspect of immune defense; other research teams found that THC inhibited the growth and spread of lung cancer and CBD of breast cancer in laboratory models.3 Clearly, chemicals in the plant could have diverse and potent effects on normal and malignant cells.

But what I found most fascinating was that we have a natural or “endogenous” cannabinoid system. In 1988, researchers identified a specific docking site, or receptor, on the surface of cells in the brain that bound THC. This first receptor was termed cannabinoid receptor 1, or CB1.4 Five years later, a second receptor for cannabinoids,CB2, was found.5 This latter docking protein was less plentiful in the central nervous system but richly present on white blood cells. Again, it was Raphael Mechoulam who discovered the first endogenous cannabinoid, a fatty acid in the brain, which he termed “anandamide.” (The name is derived from the Sanskrit word ananda, which means “bliss.”) When anandamide attached to CB1 it triggered a cascade of biochemical changes within our neurons.6

Other endogenous cannabinoids were later identified. This makes evolutionary sense, since the CB1 and CB2 receptors would not be present on our cells if we did not normally make molecules to dock on them. The physiological ramifications of endogenous cannabinoids appeared quite broad; their most impressive effects were related to perception of and response to pain.

Cannabis is one of the oldest psychotropic drugs in continuous use. Archaeologists have discovered it in digs in Asia that date to the Neolithic period, around 4000BCE. The most common species of the plant is Cannabis sativa, found in both tropical and temperate climates. Marijuana is a Mexican term that first referred to cheap tobacco and now denotes the dried leaves and flowers of the hemp plant. Hashish is Arabic for Indian hemp and refers to its viscous resin. An emperor of China, Shen Nung, also the discoverer of tea and ephedrine, is held to be among the first to report on therapeutic uses of cannabis in a medicinal compendium that dates to 2737 BCE. In 1839, William O’Shaughnessy, a British doctor working in India, published a paper on cannabis as an analgesic and appetite stimulant that also tempered nausea, relaxed muscles, and might ameliorate epileptic seizures. His observations led to widespread medical use of cannabis in the United Kingdom; it was prescribed to Queen Victoria for relief of menstrual discomfort.7

The cannabis plant contains some 460 compounds, including more than 60 cannabinoids. THC, the key psychoactive substance in marijuana, has increased from about 1–5 percent to as much as 10–15 percent in cultivated plants since the 1960s. When herbal cannabis is smoked, some 20 to 50 percent of the THC is absorbed via the lungs. When herbal cannabis is eaten, less THC reaches the brain because it is metabolized as it passes from the gut through the liver. THC accumulates in fatty tissues, from which it is slowly released, and acts primarily on CB1 receptors in the brain’s mesolimbic dopamine system, which is believed to contribute to the positive reinforcing and rewarding effects of the drug.8

While smoking or eating cannabis typically results in the user’s feeling “high,” with a relaxed, euphoric sense as anxiety and alertness decrease, some first-time users, as well as individuals who have psychological problems, can experience dysphoria, fear, and panic. Typically, when high on marijuana, there is an increased sense of sociability, although among those who have a dysphoric reaction, there can be sharp social withdrawal. Perception of time is altered, generally with perceived time faster than clock time; spatial perception also may change, and colors may seem brighter and music more resonant. High doses of cannabis can result in hallucinations, which may account for its religious use in some cultures. Yet unlike opioids, there are no reported cases of death due to a THC overdose, probably because cannabinoids do not inhibit our respiratory drive, which would result in asphyxiation. Among regular users, abstinence from marijuana can cause an uncomfortable or distressing withdrawal syndrome.

In 2008 the World Health Organization published a Mental Health Survey of 54,068 persons age sixteen and older in seventeen nations. On the basis of this survey, cannabis was found to have been used at least once by some 160 million people between the ages of fifteen and sixty-five; reported use was lowest in the People’s Republic of China, 0.3 percent, and highest in the United States, 42.4 percent, with New Zealand close behind.9

Despite such widespread use, cannabis is illegal in most countries. Harry J. Anslinger, a prominent prohibitionist, successfully lobbied Congress to pass the Marihuana Tax Act in 1937, making access to the plant costly. Anslinger was the head of the Federal Bureau of Narcotics and presented cannabis use to the public as an unalloyed danger, resulting in “reefer madness.” The American Medical Association opposed the Marihuana Tax Act, fearing that it would limit medicinal study and potential prescription of the plant. Long a part of the United States Pharmacopeia, a compendium that set standards for medicines and foods, cannabis was removed in 1942.

In 1970, Congress enacted the Controlled Substances Act, classifying marijuana along with heroin as a Schedule I drug. Drugs in this category have a proven potential for abuse and no medical value. (Opium, the source of morphine, and amphetamines are Schedule II drugs, classified as less dangerous despite their potent addictive properties.) Soon thereafter, President Nixon launched the “war on drugs,” and in 1986, President Reagan signed the Anti-Drug Abuse Act, which mandated prison sentences without parole for offenders convicted of possession and sale of all illegal drugs, including marijuana.

The study of cannabinoids, both those derived from plant sources as well as the endocannabinoids that exist naturally within our body, is now an extensive enterprise that spans the globe and links numerous scientists in both academic centers and pharmaceutical companies.

Mitch Earleywine, a prominent researcher on drugs and addiction at SUNY Albany, observed how results from current studies on marijuana are akin to Rorschach blots. “People purportedly see these ambiguous pictures in a way that reveals more about them than the ink.” Many who make public policy or are associated with interest groups, he contends, may respond to marijuana research according to the views of these groups: their interpretations say more about their own biases than about the actual data. For example, prohibitionists contend that THC often appears in the blood of people involved in auto accidents; yet they omit the fact that most of these people also had been drinking alcohol. Antiprohibitionists cite research that showed no sign of memory problems in chronic marijuana smokers; but they do not mention that the cognitive tests were so easy that even an impaired person could perform them.

Two recent reviews avoid such biases and critically examine data from more than a hundred randomized placebo-controlled clinical trials involving some 6,100 patients with a variety of medical conditions.10 Marijuana appears useful in treating anorexia, nausea and vomiting, glaucoma, irritable bowel disease, muscle spasticity, multiple sclerosis, symptoms of amyotropic lateral sclerosis (Lou Gehrig’s disease), epilepsy, and Tourette’s syndrome. (Recent clinical trials confirm many of the claims of Emperor Shen Nung and Dr. O’Shaughnessy.) Despite findings from experiments in my laboratory and others, its anticancer effects in patients are more uncertain and neitherTHC nor CBD is a proven antineoplastic agent, i.e., effective in treating abnormal growth of tissue.

Judy Foreman, an accomplished medical journalist, devotes a chapter to marijuana in her recent book A Nation in Pain: Healing Our Biggest Health Problem.11 She judiciously reviews the data on the risks and benefits of marijuana as a therapy for medical conditions marked by pain, highlighting where it appears ameliorative, where it falls short, and where there is lack of clarity about its value. Foreman writes:

To put it bluntly, marijuana works. Not dazzlingly, but about as well as opioids. That is, it can reduce chronic pain by more than 30 percent. And with fewer serious side effects. To be sure, some researchers think it’s too soon to declare marijuana and synthetic cannabinoids a first-line treatment for pain, arguing that other drugs should be tried first. But that may be too cautious a view.

Ultimately, marijuana may be used in conjunction with opioids like morphine to allow for lower doses and fewer of the side effects of the opioid family of analgesics. While chronic pain seems amenable to amelioration by marijuana, its impact on reducing acute pain, such as after surgery, is minimal.

How do cannabinoids reduce pain? Some of the benefit appears to result from cognitive dissociation: you realize that pain is present, but don’t respond to it emotionally. If you are able to detach yourself from pain in that way, there is less suffering.

Every therapy, whether a drug or a procedure, involves a tradeoff of benefits versus risks. Perhaps the most controversial and important concern around cannabinoids is whether they increase the risk of psychoses like schizophrenia. This question is most germane for adolescents and young adults. A number of studies reviewed the health records of young people in Sweden, New Zealand, and Holland who reported cannabis use, as compared to the records of those who did not. A combined or metaanalysis of results from nearly three dozen such studies linked cannabis use to later development of schizophrenia and other psychosis.12

The limitation of such observational studies is that they may suggest an association but in no way prove a causal link. Indeed, the medical literature is littered with observational studies that were taken as meaningful but later overturned when randomized placebo-controlled trials were conducted. Here the Women’s Health Initiative comes to mind. This was a randomized study, using placebos as controls, that reversed some four decades of thinking about the alleged benefits of hormonal replacement therapy among postmenopausal women in preventing dementia and heart disease. No one is likely to conduct a randomized controlled trial of thousands of teenagers, assigning one group to smoke or ingest cannabis and the other group to receive placebos. The issue of marijuana as a cofactor in the development of schizophrenia and other psychosis will therefore remain unresolved.

What is clear is that cannabis impairs cognition and psychomotor responses. Numerous studies show that it decreases a person’s reaction time and impairs his or her attention, concentration, short-term memory, and assessment of risks. These changes in psychomotor performance can last longer than the feeling of being high. Trials with licensed pilots found that marijuana impaired performance on a flight simulator for up to twenty-four hours.13 Further, most of the pilots were unaware that their performance was still impaired a day later. Several studies demonstrate associations between cannabis and collisions: drivers who use it are estimated to be some two to seven times more likely to be responsible for accidents compared to drivers not using drugs or alcohol.14

The American Psychiatric Association, in the new DSM-5, has defined a diagnosis of “cannabis use disorder.” These people had a repeated pattern of use with harmful consequences, such as inability to fulfill major responsibilities at work and persistent social problems at home. Both the DSM-5 and the World Health Organization’sInternational Classification of Diseases 10th edition (ICD-10) also include a list of possible symptoms of withdrawal from using cannabis: significant fatigue, sleepiness, psychomotor retardation, anxiety, and depression.15 Yet there is fierce argument about whether marijuana is addictive. Proponents of cannabis doubt that it can cause true addiction, a physiological condition with compulsive craving and use despite harm; they argue that any dependence is less significant than that seen with alcohol. Opponents of cannabis use, particularly those from the National Institutes of Health, affirm both dependence and addiction as real risks, although at a much lower percentage than that seen with cocaine or heroin.16

A New Leaf is a detailed account of the history of the regulation of cannabis, presenting in a blow-by-blow manner the legal and political battles around its prohibition. It opens on a celebratory note, with the legalization of marijuana for recreational use in two states:

Another prohibition is ending. On November 6, 2012, voters in Colorado and Washington were the first in the world to successfully challenge nearly a century of bad policy and misconceptions about cannabis.

In downtown Seattle, the Hotel Ändra was dressed white and blue, the team colors of Washington State’s…campaign….

Around 7 p.m., the owner of one of the largest and most successful medical cannabis dispensaries in the country arrived. Steve DeAngelo was unmistakable even in a crowd, with his signature long, tight pigtail braids and dark fedora…. Earlier that year, he was the star of his own Discovery Channel show, Weed Wars. His two Harborside Health Centers are in the Bay Area, but he had a soft spot for Seattle. Just a few months before, he had spoken at Seattle’s well-known Hempfest, attended by tens of thousands each year. “I’ve been working on this issue for my entire life…. And I know tonight…that there’s going to be a whole lot of angels dancing in heaven,” DeAngelo said, his eyes flooding.

The authors describe a similar scene in Denver:

Brian Vincente, a lawyer who advocated for medical cannabis in Colorado for nearly a decade,… took the stage. “Tonight we made history. This is something you’re going to tell your kids about,” Vincente said. “Marijuana prohibition started in 1937. The first person arrested was in Colorado.” The crowd booed. “Colorado fucking turned this thing around tonight.” And with the f-word came gaiety.

These successes resulted from a unique effort joining groups from the ends of the political spectrum:

The support of conservative Republicans and Libertarians was as important to the Colorado…campaign as that of Democrats and liberals…. The swing state of Colorado, birthplace of the Libertarian party, is decidedly purple. The Libertarian Party of Colorado emphatically endorsed Amendment 64 in May, for example, while the Colorado Democratic Party offered support but stopped short of an endorsement. The Republican Liberty Caucus of Colorado also endorsed the amendment because prohibition is “inconsistent with Republican values,” which call for more “personal responsibility” and less “federal overreach.”

Recent articles in The New Yorker17 and The Nation18 describe in a succinct and focused way the political terrain around cannabis legalization for medicinal or recreational use in the United States. The New Yorker article features Professor Mark Kleiman, a drug policy expert at the University of California, Los Angeles, who sees legalization through the perspective of a scientist, who regards it as a kind of ongoing experiment. Legalization will test a group of hypotheses about public policy, and he suspends conclusions until more data are available.

As with every social initiative, there could be negative effects and Kleiman advocates close monitoring of excessive use among adolescents and of driving under the influence when cannabis is legal for recreational use. He “appears,” according to the New Yorkerarticle, “to derive grim pleasure from informing politicians that they have underestimated the complexity of a problem.” One major concern is that when legal marijuana goes on sale in Washington State this spring, the current black market will not disappear; rather, legal over-the-counter marijuana will be competing with illicit sources. Kleiman argues that to support the legal market, there should be even greater law enforcement pressure on those who do not respect the rules. In Washington, few in government wanted to hear such a proposal.

Similarly, Kleiman is not confident that alcohol will become less appealing as marijuana is made available. While he acknowledges that alcohol is the greater danger of the two, he raises the possibility that cannabis will be used to complement drinking. Finally, he says that in the “Manichaean world of politics,” the pendulum may swing from marijuana as illegal—with sale or use of it causing imprisonment—to “going all the way to ‘We should sell it like cornflakes.’”

Unlike the cautious New Yorker piece, the articles in The Nation offer a robust endorsement of legalization. The cover of the magazine displays a photograph of a young Barack Obama flashing the V for victory sign with friends in high school clustered around the logo of the “Choom Gang.” An accompanying editorial by Katrina vanden Heuvel notes that recent presidents, including Bill Clinton, George W. Bush, and Barack Obama, all “have more or less owned up to breaking America’s drug laws” through possession or use of cannabis; if they had been observed by the police, they might well have been incarcerated, with no hope of a career leading to the White House.A New Leaf emphasizes the risks of arrest for possession. Racial discrimination, with disproportionate numbers of African-Americans arrested, is one ugly reality of prohibition:

While cannabis users who are arrested are not often sent to prison, there are still more than twenty thousand people incarcerated for mere possession. According to a comprehensive 2013 report released by the ACLU, between 2001 and 2010 more than 8 million cannabis arrests were made in the United States (88 percent for possession), and the possession enforcement alone cost more than $3.6 million in 2010.

Across the country, blacks are nearly four times more likely than whites to be arrested for cannabis possession, despite comparable rates of use; in some counties that number increases from four to thirty. Finally, 62 percent of those arrested are twenty-four or younger, which means their arrest records will follow them throughout adulthood.

All of these wasted hours, dollars, and arrests are a distraction from hard drug use and trafficking:

Again, when cannabis—which accounts for 80 percent of all illegal substance use in the United States—is removed from the drug war picture, the country can more effectively discuss and implement a new and more fitting public health approach for the remaining hard drugs.

Several years ago, I consulted on the case of a young woman with anemia. Her internist had made an exhaustive evaluation of her condition but had found no cause for it. The patient had been under a great deal of stress at work, and when I asked how she dealt with this, she said she had been smoking marijuana every night. A bone marrow examination showed reduced numbers of cells, not severe enough to be classified as aplastic anemia, but certainly abnormal in a woman in her twenties. The numerous components of cannabis are not known to be toxic to blood cells; marijuana smoking has not been reported as a cause of anemia. But I recalled that some of the illicit crops had been sprayed with toxins that might have deleterious effects on blood cell development.

So together we decided that she would suspend smoking, and over a period of months her anemia was resolved. A subsequent bone marrow examination showed full restoration of normal blood cell numbers. This was not definitive proof, but it certainly suggested that something in the grass she got from a dealer was the potential culprit. If there is not adequate oversight of the marijuana on sale, those seeking street cannabis could be exposed to dangerous contaminants.

In a forthcoming book, Weed Land, Peter Hecht, a journalist at The Sacramento Bee, charts the evolution of California’s medical marijuana law, the first in the nation.19Much of the momentum behind its passage came from a joining of forces between AIDSactivists and academic physicians like Donald Abrams at San Francisco General Hospital, who demonstrated the clinical benefits of augmented appetite and relief of pain in patients with cachexia from HIV. Medical marijuana, now legal in twenty states and the District of Columbia, is regulated like a supplement rather than a drug. There is no standardization of optimal amounts of psychoactive THC and nonpsychoactive CBD, although they must be free of toxins. (A British company, GW Pharmaceuticals, makes Sativex, an oral spray containing extracts of two standardized cannabis strains that are mixed to give exact doses of THC and CBD. Sativex was approved in several countries, but not in the United States.)

For a physician like myself prescribing a therapy, this is an uncomfortable situation, because a prescription should be exact in specifying how much drug is delivered. Further, side effects may occur in patients taking multiple other medications, due to so-called “drug-drug interactions.” Such interactions have not been well studied with THCand CBD, in part because of the restriction of access to the plant for the clinical research community. Scientists in my laboratory studied pure chemicals, THC and CBD, under strict federal oversight; we purchased the cannabinoids from chemical companies that used quality control. As Martin and Rashidian note, clinical study of the plant itself, with its scores of active chemicals, is another matter:

The federal government has imposed additional and unique restrictions on cannabis research, with little rationale—beyond politics. The federal government has enabled only one institution, the University of Mississippi, to legally grow cannabis for research on its behalf, although it is free to award additional and alternative contracts. And cannabis is the only research substance for which the government is the sole supplier. For a scientist to receive cannabis from the federal farm at the University of Mississippi, a trifecta of approvals…must be obtained from the FDA, DEA, and a Public Health Service panel.

Perhaps as states legalize marijuana, this barrier to research will be lowered, as it was for stem cell research, once restricted by federal law. And as more studies are conducted on marijuana for medical or recreational uses, opponents and enthusiasts may both discover that they were neither entirely right nor entirely wrong.

    

1. Mohamed Ben Amar, “Cannabinoids in Medicine: A Review of Their Therapeutic Potential,” Journal of Ethno-pharmacology, Vol. 105 (2006); Arno Hazekamp and Franjo Grotenhermen, “Review on Clinical Studies with Cannabis and Cannabinoids 2005–2009,” Cannabinoids, Vol. 5 (2010). ↩
2. 2
   Y. Maor, J. Yu, P.M. Kuzontkoski, B.J. Dezube, X. Zhang, and J.E. Groopman, “Cannabidiol Inhibits Growth and Induces Programmed Cell Death in Kaposi Sarcoma–Associated Herpesvirus-Infected Endothelium,” Genes & Cancer, Vol. 3, No. 7–8 (2012); X. Zhang, J.F. Wang, G. Kunos, and J.E. Groopman, “Cannabinoid Modulation of Kaposi’s Sarcoma–Associated Herpesvirus Infection and Transformation,” Cancer Research, Vol. 67, No. 15 (August 1, 2007). ↩
3. 3
   S. Ghosh, A. Preet, J.E. Groopman, and R.K. Gaju, “Cannabinoid Receptor CB 2 Modulates the CXCL 12/ CXCR 4-Mediated Chemotaxis of T Lymphocytes,” Molecular Immunology, Vol. 43 (2006); A. Preet, R.K. Ganju, and J.E. Groopman, “∆ 9 -Tetrahydrocannabinol Inhibits Epithelial Growth Factor–Induced Lung Cancer Cell Migration in Vitroas Well as Its Growth and Metastasis in Vivo,” Oncogene, Vol. 27 (2008); X. Zhang, Y. Maor, J.F. Wang, G. Kunos, and J.E. Groopman, “Endocannabinoid-like N-arachidonoyl Serine Is a Novel Pro-angiogenic Mediator,” British Journal of Pharmacology, Vol. 160 (2010); A. Preet, Z. Qamri, M. Nasser, A. Prasad, K. Shilo, X. Zou, J.E. Groopman, and R. Ganju, “Cannabinoid Receptors, CB 1 and CB 2, as Novel Targets for Inhibition of Non-Small Cell Lung Cancer Growth and Metastasis,” Cancer Prevention Research, Vol. 4 (2011); A. Shrivastava, P.M. Kuzontkoski, J.E. Groopman, and A. Prasad, “Cannabidiol Induces Programmed Cell Death in Breast Cancer Cells by Coordinating the Cross-Talk Between Apoptosis and Autophagy,” Molecular Cancer Therapeutics, Vol. 10 (2011). ↩
4. 4
   W.A. Devane, F.A. Dysarz III, M.R. Johnson, L.S. Melvin, and A.C. Howlett, “Determination and Characterization of a Cannabinoid Receptor in Rat Brain,” Molecular Pharmacology, Vol. 34 (November 1, 1988). ↩
5. 5
   S. Munro, K.L. Thomas, and M. Abu-Shaar, “Molecular Characterization of a Peripheral Receptor for Cannabinoids,”Nature, Vol. 365 (1993). ↩
6. 6
   W.A. Devane, L. Hanus, A. Breuer, R.G. Pertwee, L.A. Stevenson, and G. Griffin, “Isolation and Structure of a Brain Constituent That Binds to the Cannabinoid Receptor,” Science, Vol. 258 (December 18, 1992). ↩
7. 7
   D. Baker, G. Pryce, G. Giovannoni, and A.J. Thompson, “The Therapeutic Potential of Cannabis,” Lancet Neurology, Vol. 2 (May 2003). ↩
8. 8
   Mitch Earleywine, Understanding Marijuana: A New Look at the Scientific Evidence (Oxford University Press, 2002). ↩
9. 9
   L. Degenhardt, W.T. Chiu, N. Sampson, et al., “Toward a Global View of Alcohol, Tobacco, Cannabis, and Cocaine Use: Findings from the WHO World Mental Health Surveys,” PLoS Medicine, Vol. 5 (July 2008). ↩
10. 10
    See Amar, “Cannabinoids in Medicine: A Review of Their Therapeutic Potential,” and Hazekamp and Grotenhermen, “Review on Clinical Studies with Cannabis and Cannabinoids 2005–2009.” ↩
11. 11
    Oxford University Press, 2014 ↩
12. 12
    M. Large, S. Sharma, M.T. Compton, T. Slade, O. Nielssen, “Cannabis Use and Earlier Onset of Psychosis,” Archives of General Psychiatry, Vol. 68, No. 6 (2011). ↩

13 V.O. Leirer, J.A. Yesavage, and D.G. Morrow, “Marijuana Carry-Over Effects on Aircraft Pilot Performance,” Aviation, Space, and Environmental Medicine, Vol. 62, No. 3 (1991); D.G. Newman (Australian Government, Australian Transport Safety Bureau), “Cannabis and Its Effects on Pilot Performance and Flight Safety: A Review” (2004). ↩

1. 14
   M. Asbridge, J.A. Hayden, and J.L. Cartwright, “Acute Cannabis Consumption and Motor Vehicle Collision Risk: Systematic Review of Observational Studies,” BMJ, Vol. 344, No. 14 (2012). ↩
2. 15
   D.S. Hasin, K.M. Keyes, D. Alderson et al., “Cannabis Withdrawal in the United States: Results from NESARC,”Journal of Clinical Psychiatry, Vol. 69, No. 9 (2008). ↩
3. 16
   See Baker et al., “The Therapeutic Potential of Cannabis,” and Foreman, A Nation in Pain.  ↩
4. 17
   Patrick Radden Keefe, “Buzzkill,” The New Yorker, November 18, 2013. ↩
5. 18
   Katrina vanden Heuvel, “Why It’s Always Been Time to Legalize Pot,” and other articles in The Nation ’s “Special Issue: Marijuana Wars,” November 18, 2013. ↩
6. 19
   Peter Hecht, Weed Land: Inside America’s Marijuana Epicenter and How Pot Went Legit (University of California Press, May 2014). ↩