Harm Reduction

DrugMonkey has a post on legalization efforts for marijuana in Washington state.  I think that this might be my public health background, but why is the focus on on harm reduction and not the legal status of the drug? I have no trouble believing that use of this substance may have adverse effects over the long term.  But so do legal substances like tobacco and alcohol.  Furthermore, how does the harm stack up to the harm done by a term in a prison?  A lifetime of reduced employment opportunities, acculturation in a brutal environment as well as being a victim of the violence that occurs in jails.

Why not look for middle grounds?  A heavily taxed substance that minors are prevented from buying (the tobacco model)?  Decriminalization so that use equals fines and not police breaking down one's door (the Canadian model)?

Why is the focus not on maximizing public health outcomes?

Quote of the day

From Comrade Physioprof:

When you ask people overly simplistic and broad "gotcha" questions in a provocative and accusatory manner, you shouldn't be surprised to receive glib uninformative answers. If you develop genuine professional relationships with people within NIH and treat them like the fellow scientists they are, you will receive more thoughtful honest answers.

This concept has broad applicability in many areas of debate and it is worth keeping in mind when one tries to bring up difficult questions. Sometimes you need to be able to build bounds of trust to deal with delicate issues and, while not as "cool" as being the crusader, it may be the way towards real reform.

NIH Merger

From DrugMonkey:

Instead it makes it look very much as if NIAAA is being subsumed into NIDA simply to make statutory way for the creation of this new translational medicine Center.

And that is a whoooole ‘nother ballgame. Because the discussion now should be “Is NIAAA worth losing in favor of the new Center?”.

To remind my readers, my approval of the NIDA/NIAAA merger is based on the stipulation that merging ICs is a good idea, will lead to efficiencies, etc. And that there is a general will to further scale back the number of ICs. Given this motivation the NIDA/NIAAA merger is about as obvious as can be. If those goals are not a given, then I’m in a very different stance about this current merger.

And I really, really do not like disingenuous bait-and-switch arguments. This is starting to smell like one.

I was never really sold on the merger, myself, as I thought alcohol research was different (in some interesting ways) then research on other recreational drugs. That being said, I wonder if (at some point) it might be worth rethinking the 27 centers from first principles and making sure that they are the one that best serve the goals of public health?