Few things about the marijuana issue inflame me more than workplace and student drug testing.  I’m still trying to imagine how, if you had a time machine, we could visit Thomas Jefferson and the other hemp farmers discussing our Bill of Rights and explain to them in America of the future, employers routinely seize citizens’ urine to determine their fitness for employment and discriminate against them if hemp shows up in their system.  I think Ben Franklin would actually LOL.

Of course we all know that cannabis metabolites show nothing about one’s current impairment and will remain in one’s system for weeks or months following cessation of use.  We’ve talked about the perverse incentive this creates to use alcohol and other toxic addictive drugs that clear from one’s system in two to three days.  And now, this information from the American Psychiatric Association leads me to better understand why we’re seeing such an uptick in prescription drug abuse.

Medical News: APA: Drug Test Results Often Flawed – in Meeting Coverage, APA from MedPage Today.

NEW ORLEANS — That poppy seeds can lead to false-positive results on tests for opioid abuse is not just an urban legend, researchers said [at the American Psychiatric Association's annual meeting last May].

Another example is that most standard drug tests don’t screen for the opioid drug oxycodone, as well as a handful of other opioids including methadone and fentanyl, noted Smith, who conducted the research while he was at Boston Medical Center.

Opioid tests screen for morphine and codeine, which are two of the most common metabolites of many — but not all — opioids. They’re not metabolites of oxycodone, methadone, fentanyl, tramadol (Ultram), and buprenorphine (Subutex, Suboxone), Smith said.

Similarly, only certain metabolites of benzodiazepines are detected on most assays. That means diazepam, nordiazepam, and oxazepam (Serax) will be detected, but alprazolam (Xanax), lorazepam (Ativan), and clonazepam (Klonopin) aren’t frequently screened.

In their review, the researchers found that drug tests generally have a sensitivity of 90% to 95%, and a specificity of 85% to 90%. These numbers are a “pretty good basis” for making clinical decisions, Smith said, but that means “one in 20 [tested patients] are going to have inaccurate results, and those are more likely to be false positive than false negative.”

Many substances aside from poppy seeds cause these false-positives. Cold medications can give a positive read on amphetamines, as can bupropion (Wellbutrin) and tricyclic antidepressants.

Sertraline (Zoloft) and oxaprozin (Daypro) can alert physicians to a benzodiazepine problem when there is none.

The HIV medication efavirenz (Sustiva) can come up as a positive for marijuana use, and dextromethorphan, rifampin, and quinolones could show as an opioid problem.

There is a Jackson’s Food Store – a gas station / convenience store chain out West – that is two blocks from my home.  I walk my dog there every day as I pick up my fountain Diet Coke refill for lunch.  I’ve gotten to speak with most of the employees about marijuana – my pot leaf hat leads to lots of these conversations.  One of the kids pumping gas there is a sweet young man who is a migraine sufferer whom I’ve told would be a shoo-in for a medical marijuana card.

Then one day recently I notice that there are a whole bunch of new workers.  I find out that the store had come up $1,800 short in an audit, so in response, Jackson’s was drug testing all their employees.  Three employees admitted to occasional marijuana use and now they are unemployed.  There is no evidence that any of them were filching cash from register and since the firings the shortages from the till haven’t ceased.  But Jackson’s feels better, I guess, for having some scapegoats to blame.

Ironically, the one young man who could really use medical marijuana still has his job.  ”I only toke a tiny bit and only if the pain is just unbearable,” he told me, “because I just can’t lose this job – I have to take care of my wife and kid.  Luckily I hadn’t had a bad migraine for a few weeks, so I was able to pass the test.”  Even if he had a medical marijuana card, his job wouldn’t be protected.  My wife, a migraine patient herself, volunteered that her regular use of cannabis has turned what used to be weekly migraines to seasonal migraines – maybe four a year – and when they do come, they are moderate and not “drill a hole in my head” painful like before.

Now some would say, “Well, they knew the rules on drug testing; they don’t have to work there.”  Keep in mind that Portland, Oregon is suffering some >10% unemployment.  And then try to imagine your life if finding aspirin or ibuprofen or acetaminophen or naproxen in your system meant the end of your job and you have a splitting headache.

The Examiner family of online newspapers is now featuring the retired locksmith (and thus, drug policy expert) John English as a regular columnist.  It seems his entire series of columns is dedicated to pushing reefer madness.

In “Marijuana Crosses the Placenta“, John tortures the language he’s named after with fine writing like this:

Effects on the fetus, though scientifically difficult to evaluate, for a variety of reasons, the detection of metabolites in meconium establishes fetal drug exposure. The effects on the babies after birth is obvious.

Judging from his various cut’n'pastes from scientific articles I doubt he understands, I think his argument is that women who smoke a lot of pot while pregnant risk harming their babies, so we should lock them up.  Wait’ll he sees the statistics on fetal alcohol syndrome!

In “Who Populates the Prison System“, John claims to debunk the idea pushed by “pro-drug advocates and their financial backers (Soros, Sperling, et al.)” that the prisons are filled with non-violent marijuana possessors:

# The massive numbers of people in prison for marijuana, are / were smugglers and distributors.

# These skewed facts ignore that when a person actually is incarcerated for simple possession, invariably it’s because they’ve cooperated and been allowed to plead to a lesser charge!

John doesn’t understand, though, that a “smuggler/distributor” of marijuana can be a pot possessor who made the mistake of keeping his two separate strains in two separate baggies, or keeps Ziploc sandwich baggies in his home, or owns a postal scale, or grew more than one plant, or keeps a legal firearm.  He also doesn’t realize that folks on parole or probation who get busted for possession technically go back to prison for their original crime, not the pot possession, so they don’t show up in statistics as pot prisoners.  But it is refreshing to see him admit that there are “massive numbers of people in prison for marijuana” as he beats up his strawman.

In “Losing Our Youth to Depression“, John explains that marijuana doesn’t treat depression, it causes depression:

The marijuana user is in a constant state of depression interspersed with “short bursts of feeling almost normal again.” The user, when he’s reached out and achieved that “high,” he has a temporary reprieve from that constant, marijuana-induced state of depression, but it returns as the “high” fades.

That’s the cause, the scenario . . . ; users seek, the non-depressed state, they perceive as a “high”. They’re wrong; it’s the state they were in before – it’s the absence of depression. Over and over, they’re drawn into the ‘fog of marijuana addiction’ which has caused them to perceive it wrongly. The user has unknowingly, only taken a step down a rung, on the ladder of normalcy!

So I’ll bet when John learns that the suicidal/homicidal Columbine shooters, Eric Harris and Dylan Klebold, and just about every high-profile school shooting you can name in the past twenty years involved depressed teens who were prescribed SSRI anti-depressants, he’ll be eager to pump out a few columns about how we should be locking up people in possession of Paxil, Effexor, Celexa, Prozac, Zoloft, Luvox, Anafranil, Lexapro, Wellbutrin, etc.

In “Addiction to cannabis and mental disorders“, John reveals the insidious evil of marijuana – the “potheads” are seducing our youth into their debauched lifestyle (I guess we’ve been borrowing strategy from the “gay agenda”):

The most convincing reason why potheads must remain criminals, why marijuana must remain illegal, is their targeting of children. That behavior in and of itself reveals that they suffer from a deep psychological insufficiency, a need to draw children into becoming like them – whether it’s a need to justify their own beliefs or some other motivation, it doesn’t matter! They’re damaging future generations and doing so intentionally.

You know who’s targeting children, John?  Pot dealers who aren’t required to check IDs, a million of whom are teenagers themselves.  You know who else targeted children?  Alcohol and tobacco companies with their “Budweiser Frogs” and “Joe Camel”, but since those drugs are legal, we were able to set strong advertising restrictions on those products, create effective anti-youth drinking and smoking educational campaigns, and reduced teen drinking and smoking to the lowest levels ever recorded.

In “What is wrong with smoking marijuana for medicinal purposes“, John cites a video of “Nathan Edelman” (he means Drug Policy Alliance’s Ethan Nadelmann), which is actually video of former NORML Director Richard Cowan taken way out of context to illustrate our alleged secret agenda of telling pot smokers to lie about how marijuana helps them medically so we can legalize all drugs (and, naturally, recruit the children into our debauched lifestyle).

When considering at this question, one must take into account two related issues: 1) that the whole plan to make marijuana legal was published in “High Times.” They issued a call, compelling users to come forward saying that pot helped their suffering.

And there’s another part: 2) that a survey showed that medical marijuana cardholders had been smoking pot for an average of 17 years! That in itself, brings the whole system under more suspicion – - – for what if, marijuana does cause one to think their “medicine” helps their condition when it is instead, actually causing or contributing to it?

Then, there’s two further question that needs to be asked:

1) What weed is smoked without the particulate matter, tars, and (over 400 chemical compounds in the smoke) not causing harm? The doctor’s oath is “First, do no harm.”

2) If people who were already breaking the law using an illicit drug for 17 years before the system allowed this pseudo-legal use, do they have the credibility to allow us to believe this actually helps?

If you were nauseous, in chronic pain, spastic, prone to seizures, or were losing your eyesight to glaucoma, and you smoked a joint 17 years ago and found it helped you medically, would you choose to live in misery for another 17 years until it became legal to use, just so you could have some credibility in John English’s view?

You can read more of my responses to John English in the comments sections of his articles in the hyperlinks above.  Feel free to leave some of your own comments, too.

Last year there was a horrible tragedy in Omaha when Robert Hawkins, 19, went to the mall and began shooting innocent people, killing eight and himself.  Yesterday, Hawkins’ mother Molly appeared on the Dr. Phil television program so the two of them could “get real” (to mock one of Dr. McGraw’s favorite catchphrases) about what led her son to go on a shooting rampage.

Download audio file (dr-phi-omaha-shooting.mp3)

While Dr. Phil did emphasize Robert’s troubled family life, history of depression and psychotic episodes, and easy access to an AK-47 assault rifle in exploring the reasons behind Robert’s suicidal rampage, he also goes to great lengths to emphasize Robert’s use of cannabis.   (I hope you enjoy this… Dr. Phil charged me $6 just to get the transcript of the program…)

TRANSCRIPT from JANUARY 07, 2009

McGRAW: Robert Hawkins’ mother says she did not see the warning signs because it was one year ago that her 19-year-old son walked into the Von Maur department store at Westroads Mall in Omaha, Nebraska, with an AK-47 and killed eight people. According to the police chief, Robert fired more than 30 rounds, then he took his own life.

… Your questions to me–and I get so many of them–are, `Dr. Phil, why? Why, why does this happen? Who does this? How can we spot it before it happens to protect ourselves or our children?’ Maybe it’s one of your own children acting strange. Maybe it’s one of their friends. Maybe it’s a co-worker or somebody that you’re around. You say, `How can we protect ourselves?’ We’ve seen this all too often. Columbine, Virginia Tech, Northern Illinois University, the Utah Trolley Square shooting. There are tragically just too many to name. But could these have been prevented?

… Did you smoke marijuana with this kid?

MOLLY: Yes, I did. 

McGRAW: At what age?

MOLLY: When he was eight–he was 18 1/2, almost 19.

McGRAW: OK. And you understand that’s illegal, right?

MOLLY: Absolutely.

McGRAW: But you did it anyway.

MOLLY: Yes.

McGRAW: He gets depressed, starts abusing alcohol and drugs, you knew that was going on.

MOLLY: Yes.

McGRAW: While you were smoking marijuana with him.

MOLLY: Yes.

McGRAW: Did it seem like you were contributing to the problem?

MOLLY: I didn’t view it as contributing to the problem as much as I viewed it as trying to wean him off of those kind of things.

McGRAW: OK. It’s during this period, just a few months before this happened, that you’re smoking marijuana with him, correct?

MOLLY: Right.

McGRAW: How long before the shooting was that going on?

MOLLY: I only did it one time with him and it was in–it was like the day of Thanksgiving.

Robert Hawkins was estranged from his mother at the time of the shooting and was living with another adult woman and her son. Dr. Phil is speaking with the other woman when he turns to address Hawkins’ mom, Molly:

McGRAW: OK. You say you have a total and complete disrespect for her.

MOLLY: Absolutely.

McGRAW: Why is that?

MOLLY: Mainly because she knew exactly what Robert was doing. One of the reasons that I smoked marijuana with Robert is because Robert told me that she and her son smoked marijuana and he really enjoyed that relationship that they seemed to share.

…McGRAW: And I’d say there’s a–there’s a point at which, as parents, we have to recognize we are in over our heads. And if you are dealing with someone that is actively suicidal and talking about it on a regular basis, is abusing drugs and alcohol, is involved with a history of threats, of violence against stepmother, friends, family, whoever it may be, there’s a point at which you have to say, `I need to get some help with this. I don’t know what to do.’ And when that–when you get to the point that you say it makes sense to sit down and smoke illegal drugs with your underage son, then that’s bad judgment.

Dr. Phil references Robert’s marijuana smoking four times (3 “marijuana”s and 1 “smoke illegal drugs”).  Do you suppose he’s trying to influence his audience by leading them to think marijuana use turns people into violent sociopaths?  Because if Dr. Phil is looking for a pharmacological reason for Robert’s imbalance, he’s not paying very close attention to all the possibilities?

Running a search on the words “depressant” and “medication” and “anti-” brought me exactly one match in an entire 60-minute show / 19 page transcript:

McGRAW: All right. Let’s talk about what led up to this. Timelinewise, you say that Robert was molested in the first three years of his life, correct?

MOLLY: Yes.

McGRAW: And that had become violent during pre-school.

MOLLY: Yes.

McGRAW: Was put into a mental hospital at age four.

MOLLY: At three and a half he was there.

McGRAW: OK. He was diagnosed with depression and PTSD and put on anti-psychotics for a month.

And that led me to my good friend, The Google.  I wonder what fascinating things I can learn about young male spree killers and anti-depressant medications…

Anderson Cooper 360 on CNN (where the transcripts are free):

SHAWN SANDERS, FRIEND OF ROBERT HAWKINS: I’m not sure to the level of his depression. I just know he was on antidepressants for the last couple of months. And I guest — I guess it was just getting worse over time, with the loss of his job. And I guess he had issues going on with a girlfriend at the time. 

Let’s take a look at the horrible mass shootings perpetrated by depressed sociopathic young men, some of which Dr. Phil mentioned earlier (from Citizens Commission on Human Rights):

• September 28, 2006: Bailey, Colorado: Duane Morrison, 53, entered Platte Canyon High School and shot and killed one girl, and sexually assaulted 6 others. Antidepressants were found in his vehicle.
• March 21, 2005: Red Lake Indian Reservation, Minnesota: 16-year-old Native American Jeff Weise was under the influence of the antidepressant Prozac when he shot and killed nine people and wounding five before committing suicide.
• April 10, 2001: Wahluke, Washington: 16-year-old Cory Baadsgaard took a rifle to his high school, and held 23 classmates and a teacher hostage while on a high dose of the antidepressant Effexor.
• March 22, 2001: El Cajon, California: 18-year-old Jason Hoffman was on two antidepressants, Effexor and Celexa, when he opened fire at his California high school wounding five.
• March 7, 2000: Williamsport, Pennsylvania: 14-year-old Elizabeth Bush was on the antidepressant Prozac when she blasted away at fellow students in Williamsport, Pennsylvania, wounding one.
• May 20, 1999: Conyers, Georgia: 15-year-old T.J. Solomon was being treated with a mix of antidepressants when he opened fire on and wounded 6 of his classmates.
• April 20, 1999: Columbine, Colorado: 18-year-old Eric Harris was on the antidepressant Luvox when he and his partner Dylan Klebold killed 12 classmates and a teacher and wounded 23 others before taking their own lives in the bloodiest school massacre to date. The coroner confirmed that the antidepressant was in his system through toxicology reports while Dylan Klebold’s autopsy was never made public.
• April 16, 1999: Notus, Idaho: 15-year-old Shawn Cooper fired two shotgun rounds in his school narrowly missing students; he was taking a mix of antidepressants.
• May 21, 1998: Springfield, Oregon: 15-year-old Kip Kinkel murdered his own parents and then proceeded to school where he opened fire on students in the cafeteria, killing two and wounding 22. Kinkel had been on Prozac.

It isn’t even controversial to point out that these antidepressant drugs lead to violence and suicidal ideation among young men.  Such warnings are clearly printed on the labels of many of these drugs.

“Antidepressants increase the risk of suicidal thinking and behavior … in children and adolescents with major depressive disorder and other psychiatric disorders,” the warning begins. Those risks must be balanced against clinical need, the label indicates in a warning surrounded by a black box, hence the “black box” designation.

The new warnings will be carried by all antidepressants, including Anafranil, Aventyl, Celexa, Cymbalta, Desyrel, Effexor, Elavil, Lexapro, Ludiomil, Luvox, Marplan, Nardil, Norpramin, Pamelor, Parnate, Paxil, Pexeva, Prozac, Remeron, Sarafem, Serzone, Sinequan, Surmontil, Symbyax, Tofranil, Tofranil-PM, Triavil, Vivactil, Wellbutrin, Zoloft and Zyban.

Most of the rest of the civilized world won’t even allow doctors to prescribe these medications to young people, but here in the United States, there is a lot of money to be made by scaring people to “tell their doctor”* to prescribe the latest pill to make up for bad or negligent parenting.

Why wouldn’t Dr. Phil pay as much attention to the cocktails of anti-depressant pharmaceutical medications Robert Hawkins was taking as to the cannabis he was smoking?  Short answer: cannabis doesn’t buy any commercials on the Dr. Phil show.