Pubdate: Tue, 29 Jun 2004
Source: United Press International (Wire)
Copyright: 2004 United Press International
Author: Ellen Beck, United Press International
Note: Ellen Beck is UPI's Health Policy Editor.
Note: UPI's Mike Kirkland at the Supreme Court contributed to this report
Bookmark: http://www.mapinc.org/mmj.htm (Cannabis - Medicinal)
Bookmark: http://www.mapinc.org/decrim.htm (Decrim/Legalization)
Bookmark: http://www.mapinc.org/find?232 (Chronic Pain)

ANALYSIS: MEDICAL MARIJUANA DEBATE RENEWS

WASHINGTON, June 29 (UPI) -- The decision by the Supreme Court to hear a 
California medical marijuana case this session renews the debate whether to 
legalize medical use of marijuana at the federal level and have a uniform 
national policy regulating it.

The Supreme Court Monday put on its docket for consideration a case from 
patients who used marijuana after the treatment was recommended by their 
physician. Note the doctors did not write a prescription -- that would have 
taken them out of state law and into federal regulations and licensure 
troubles.

This is not the first time medical marijuana has been considered by the 
court. A 2001 decision in United States vs. the Oakland Cannabis Buyers' 
Cooperative was unanimous: There was no medical-use exception to the 
federal law prohibiting the growing and distribution of marijuana.

This reconsideration, from the 9th U.S. Circuit Court of Appeals, looks at 
whether Congress exceeded its authority when it banned the personal use of 
medical marijuana. In Ashcroft et al. vs. Raich et al., the lower court 
ruled that Congress, in passing the Controlled Substances Act under the 
constitutional clause authorizing it to regulate interstate commerce, 
exceeded its power when it included medical marijuana.

The high court decision to hear the case comes as the House of 
Representatives next month is set to consider an appropriations bill, 
during which it is expected supporters of medical marijuana will introduce 
an amendment ordering the Justice Department to stop interfering with 
states that have passed laws allowing for such use. A similar amendment 
last year got 152 votes in the House.

Nine states have thumbed their noses at federal law, passing legislation 
allowing the possession or growth of marijuana for medical purposes if such 
treatment is supported by a physician. The most recent state is Vermont, 
where Republican Gov. James Douglas, who was concerned about illegal drug 
use and skeptical about the medical efficacy of marijuana, allowed the 
legislation to become law in May without his signature because of its 
popular support.

"I feel, as most Vermonters do, that we must do what we can to ease the 
pain of dying Vermonters," Douglas said in a statement.

Arizona passed an initiative in 1996 but it never got off the ground 
because it made medical marijuana legal with a prescription. Maryland last 
year passed a law that does not make it legal but says if a person is 
arrested for marijuana possession and they can provide a medical defense, 
then the maximum fine is $100, as opposed to the regular punishment of a 
year in jail.

"I do think we are really approaching the point of political mass," said 
Bruce Mirken, director of communications for the Marijuana Policy Project 
in Washington.

"In the long-run patients will be protected," Mirken told United Press 
International. "It's a question of when, not if. If we lost (at the Supreme 
Court), it won't stop the progress of what is obviously an issue of science 
and justice."

Medical marijuana represents a growing state and federal clash, pitching 
healthcare against law enforcement at the policy level. A federal policy 
could ensure those who benefit from medical marijuana can get it and 
researchers studying what marijuana can and cannot do medically will have 
access to it -- all the while helping in the effort to keep it off the 
streets and away from kids.

Federal regulation of medical use could streamline what might become a 
confusing legal patchwork of different state regulations. Politics and 
science, however, stand in the way.

The politics of legalized medical marijuana are bipartisan. Neither the 
Clinton administration nor the Bush administration supported it; however 
Mirken said the Bush administration has been more aggressive in its 
opposition and its enforcement against patients who use it.

Sen. John Kerry, the presumed Democratic candidate for president, has said 
publicly that if elected he will stop Drug Enforcement Administration raids 
on seriously ill patients who use marijuana for pain control. He also said 
during the campaign he supports research into the efficacy of medical 
marijuana, but left open the issue of legalizing it pending more scientific 
evidence.

A real sticking point from a regulatory standpoint, though, is providing 
scientific evidence of medical marijuana's efficacy. The War on Drugs has 
made it tough for researchers to launch studies and get quantities of the 
drug needed to perform the research.

Mirken forwarded to UPI, however, lists dozens of U.S. medical groups that 
support some aspect of medical marijuana, whether it be full legalization 
under a physician's care or research into its effectiveness treating 
disease and helping patients cope with severe, chronic pain.

Medical evidence showing marijuana's efficacy remains scattered and 
inconclusive, although there is plenty of anecdotal evidence it eases 
chronic pain.

In 1999 the Institute of Medicine concluded smoked marijuana was 
potentially effective for a short list of symptoms and called for rigorous 
clinical trials and development of a delivery system so patients do not 
have to inhale. The 18-month, $1 million study said marijuana, as compared 
to the legal, synthetic pill Marinol containing the active ingredient of 
marijuana, is potentially effective in treating chronic pain, nausea from 
cancer chemotherapy, lack of appetite and wasting in AIDS patients.

It rebuked beliefs marijuana was effective for treating glaucoma, 
Parkinson's or Huntington's diseases, seizures and migraines.

There is also a strong opposition to medical marijuana from the DEA. It 
uses scientific research to point out the health ill effects of marijuana 
use include the cancer-causing agents inherent in smoking the plant, 
increased risk of heart attack, the potential for a weakened immune system, 
the conclusion by some studies marijuana acts as a gateway to stronger 
drugs -- as well as its own declaration that medical use interferes with 
the agency's ability to keep marijuana off the street.

Mark R. Trouville, special agent in charge of the DEA's New England Field 
Division, testified before the Vermont House Committee on Health and 
Welfare, during April deliberations on its legislation, that medical use 
laws obstruct federal law.

"More than seven years of experience have demonstrated that when a state 
legalizes marijuana under its law, residents are effectively encouraged to 
violate federal drug laws," he testified. "I would like to point out that 
the bill before you today is conspicuously silent with regard to the fact 
that the cultivation, distribution, and possession of marijuana, even in 
compliance with the bill, would violate federal law and subject the 
individuals engaged in such conduct to criminal and civil prosecution. That 
omission points to a glaring practical issue in the legislation -- there is 
simply no way for it to be given effect without encouraging and 
facilitating trafficking in a federally controlled substance."

The government, however, already has experience growing marijuana for legal 
use. The National Institute on Drug Abuse set up a compassionate use 
program in 1978 under an investigational new drug permit to settle a 
lawsuit against the government. Physicians who received such an IND could 
provide marijuana to their patients. The program ended in 1992 but the NIDA 
has continued to supply medical marijuana to a handful of patients 
grandfathered in under that program.

To provide for that program and other marijuana research, NIDA contracted 
with the University of Mississippi to grow cannabis for research purposes.

The Supreme Court has given medical marijuana advocates additional steam to 
continue their fight to get state laws passed and it could help shape the 
larger debate over federal legalization. A decision in favor of the 
California patients could provide a safe harbor for users in states that 
have medical use laws, while a decision against could ensure the state and 
federal divide over medical use grows wider.
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MAP posted-by: Terry Liittschwager