Marijuana As Medicine? The Science Beyond the Controversy (2001) / Chapter Skim
Currently Skimming:
Legal Issues
Legal Issues
Pages 156-172
The Chapter Skim interface presents what we've algorithmically identified as the most significant single chunk of text within every page in the chapter.
Select key terms on the right to highlight them within pages of the chapter.
From page 156... ...
This is particularly true at the state level, where laws vary widely; local enforcement is even more variable. The picture is considerably clearer at the national level, and it applies to every resident of the United States (except 156
|
From page 157... ...
Then, for three decades after passage of the federal Marijuana Tax Act in 1937, the drug essentially disappeared from medical use in this country. Several states had already outlawed marijuana for nonmedical purposes by 1920.
|
From page 158... ...
In response to this development and also out of an effort to consolidate and reform federal narcotics laws, Congress passed the Comprehensive Drug Abuse Prevention and Control Act in October 1970. The portion of this law that concerns drug classification and control, known as the Controlled Substances Act (CSA)
|
From page 159... ...
Among them was Robert Randall, a glaucoma patient whose troubles led to two important legal developments concerning medical marijuana use: the creation of a government-sponsored marijuana treatment program and the birth of the "medical necessity" defense against the charge of marijuana possession. In 1975 Randall was arrested for cultivating marijuana on his porch in Washington, D.C.
|
From page 160... ...
government.6 In 1991 the Public Health Service closed the Compassionate Use program for smoked marijuana after a National Institutes of Health review concluded that marijuana was not the best treatment for any of the patients who were receiving it. Increasing numbers of AIDS patients were applying to the program, and its administrators worried that smoking marijuana would be harmfu]
|
From page 161... ...
there is no clear alternative for people suffering from conditions that might be relieved by smoking marijuana." Such patients could be treated as the subjects of individual clinical trials that would be overseen by a medical review board. Patients would receive marijuana to smoke under close medical supervision and only after being informed of their status as experimental subjects using a harmful drug delivery system.
|
From page 162... ...
Once this defense was allowed, the prosecutor dropped all charges against the defendant.~° The medical necessity defense also has failed for a variety of reasons. Some defendants have lost because they did not make an effort futile though it might have been to obtain marijuana through legal channels such as the federal Compassionate Use or state research programs.
|
From page 163... ...
Lastly, some states have established their own controlled substances regulations in which marijuana has been assigned to Schedule II (a largely symbolic measure since the federal CSA prevails) .~2 Two groups that advocate legalizing medical marijuana, NORML and the Marijuana Policy Project, maintain databases of state marijuana laws on their web sites.
|
From page 164... ...
Time has shown, however, that medical marijuana initiatives are much easier to pass than they are to implement. As long as marijuana remains in the federal government's Schedule I, the threat of prosecution to anyone involved with its procurement or use has deterred all but a minority of doctors, patients, and providers of medical marijuana from establishing public distribution contemplated by the new state laws.~3 For physicians the potential consequences of recommending marijuana to patients include the loss of DEA licenses to prescribe controlled substances as well as cancellation of Medicare and Medicaid contracts.
|
From page 165... ...
Nevertheless, the distinction between recommending marijuana use and "aiding and abetting" patients in obtaining an illicit substance is a fine one, as several state medical associations have noted. For example, in a 1999 bulletin entitled "Medical Use of Marijuana," the Washington State Medical Association cautions its members as follows: Physicians must not prescribe marijuana.
|
From page 166... ...
Ensuing state and federal lawsuits have forced many of these public clubs to close. Those that remain open do so in cooperation with local authorities.
|
From page 167... ...
LEGAL ISSUES 167 FIGURE 11.1 Contrasting photos of cannabis buyers' clubs in Los Angeles and San Francisco, California. (Top photo by Tyler Hubby, Los Angeles Cannabis Resource Center, identifiable people: lay Fritz, Mirron Willis, Craig Poore, and Michael Goldberg.
|
From page 168... ...
Bowing to federal pressure, the cooperative ceased marijuana and at the time this book was written, operated only as a patient registration center. But in July 2000, a ruling of the Federal District Court restored the right of the Oakland club to distribute marijuana to patients with a serious medical condition who will suffer imminent harm without marijuana, and who have no legal alternative to marijuana for effective treatment for their illness.
|
From page 169... ...
RESEARCH AND REGULATION One point on which both sides in the medical marijuana debate can agree is the need for definitive clinical research on marijuana. As a National Institutes of Health committee noted in 1997, "until studies are done using scientifically acceptable clinical trial design and are subjected to appropriate statistical analysis, the questions concerning the therapeutic utility of marijuana will likely remain much as they have to date largely unanswered."~5 But in order to conduct such research, scientists must thread their way through a complex maze of regulations, beginning with the restrictions imposed by the federal Controlled Substances Act.
|
From page 170... ...
Rather than develop whole marijuana as a licensed drug, the stated goal of the NIDA program is to determine whether active compounds in marijuana can be safely delivered as medications that meet the FDA's standards for pharmaceuticals. These policies follow the recommendations stated in the IOM report, which emphasized that even trials of smoked marijuana be directed toward developing smokeless delivery systems for cannabinoids.
|
From page 171... ...
The workshop report also notes the heavy regulatory burden on researchers who study controlled substances, particularly Schedule I substances such as marijuana. As a result, the report concludes, many scientists "have been discouraged from pursuing research with these substances." A 1995 IOM report on the development of addiction medication reached much the same conclusion, leading its authors to recommend that federal regulations be modified to remove barriers to research on controlled substances.~7 ...
|
From page 172... ...
Marijuana Rescheduling Petition, Docket No. 86-22, Opinion and Recommended Ruling, Findings of Fact, Conclusions of Law and Decision of Administrative Law Judge Francis L
|
Key Terms
This material may be derived from roughly machine-read images, and so is provided only to facilitate research.
More
information on Chapter Skim is available.