Drug Policy, Politics, and the Law

For the past 8 years, much health and science policy in the United States has been informed more by ideology than by science. The Executive branch of our Federal government has generated executive orders, promulgated legislation, vetoed other legislation, and directed policy reflecting a highly conservative—some would say overly narrow—philosophy and perspective. As this issue of the Journal appears in the first quarter of a new Federal administration, we are witnessing a shift toward science-informed policy. Change in a bureaucracy as huge as our Federal government takes time. Let us hope that this change will occur soon. There is value in carefully reviewing the national experience of the last 8 years with a hope that we can learn form it.

The impact on the National Institutes of Health, the Food and Drug Administration, and other Federal agencies from Federal policy in recent years has been profound. Many of us believe that scientific progress and even the health of the citizenry have suffered. Two egregious examples of this ideologically driven policy include seemingly arbitrary restrictions on drug availability and health professionals being allowed—even encouraged—to place their personal beliefs above those of their patients.

Justice is not served by such ideologically driven policy. That is a carefully considered conclusion based on over 4 years of policy analysis. Since 2004, this editor has collaborated with an interdisciplinary group of scholars and practitioners, including physicians, attorneys, judges, biomedical scientists, ethicists, legal and economic scholars, and others in a detailed analysis, which led to the publication of a book entitled Drugs and Justice: Seeking a Consistent, Coherent, Comprehensive View.¹ A part of the activity that produced the book also led us to put on an interdisciplinary symposium entitled “Drugs: Addiction, Therapy, and Crime” that included presentations by leading biomedical, legal, and ethics scholars, and national policy analysts and regulators.²

Peter J. Cohen, MD, JD, a keynote speaker at the symposium, provided a scholarly and detailed analysis of marijuana policy in the United States. Dr. Cohen is eminently qualified to do so. He serves as Chair of the Physicians Health Program of the District of Columbia Medical Society and Vice Chair of the Institutional Review Board of the Intramural Research Program of the National Institute on Drug Abuse. Formerly, he was Professor of Anesthesiology at the University of Pennsylvania Medical Center and Professor and Chairman of Anesthesiology at the Universities of Colorado and Michigan Medical Centers.

The lead article in this issue of the Journal is the first of a two-part paper by Dr. Cohen entitled “Medical Marijuana: The Conflict Between Scientific Evidence and Political Ideology.”³ The concluding part of this paper will appear in Volume 23, Issue 2 in 3 months. Dr. Cohen's objective analysis demonstrates the serious risks of ideologically driven policy that ignores the relevant science. Hopefully, papers such as this reflect the current Federal administration philosophy and will see a gradual return of Federal agencies toward more balanced and objective policy.

We call upon pain clinicians and investigators to become better informed on Federal policy. The serious paucity of funding for pain and symptom control research is well documented. Funding policy should also be a priority about which we communicate with our elected representatives.⁴

When science more effectively informs policy and policy informs law, all will benefit.

Welcome to Informaworld

One year ago we informed our readers that our former publisher, The Haworth Press, was purchased by the large British publisher Taylor & Francis (T&F).¹ The transition from the Haworth imprint to the Informa Healthcare imprint has taken place and Volume 22 for 2008 was published by Informa Healthcare, an American T&F subsidiary. The transition is now complete and the Journal Web page has been migrated from http://Haworthpress.com to the far more extensive platform http://www.Informaworld.com. The Journal Web page URL is now http://Informaworld.com/JPPCP.

The Haworth Press site ran in tandem with the informaworld site until March 30, 2008, when the Haworth Press site was closed. Former Haworth journal titles are now on www.Informaworld.com. Volume 23 for 2009 of this Journal will not be added to the www.Haworthpress.com site, nor will any new accounts be created on that site. The Haworth Press electronic access Journal license allowed entree only to those Journal volumes that the subscriber had purchased. Informa Healthcare will now allow access to current content with a current subscription, along with a back file of all digitized issues of the Journal of Pain & Palliative Care Pharmacotherapy to from Volume 19 for 2005. Purchased content will be available in perpetuity.

The vast majority of electronic subscribers are institutions such as health sciences libraries. In most cases, online access has already been transferred automatically to each subscribing institution's Informaworld account. Personal electronic version subscribers and new institutional subscribers that do not already have an Informaworld account will receive e-mail instructions detailing how to access their electronic subscriptions. Questions may be directed to the Informaworld support team at [email protected].

Our goal is to provide access to Journal content in both electronic and print formats for all who subscribe to each or both formats. We hope that this transition causes minimal disruption to our readers and subscribers. Your patience during this transition is very much appreciated and we hope that the move to informaworld will provide an improved user experience in the long term.