Medical Marijuana, a Casual User's Tale

By Lessley Anderson
Source: New York Times

San Francisco -- I am not one of the "seriously ill Californians" that Proposition 215, the state's medical marijuana law passed by voters in 1996, was designed to help. I'm a 31-year-old marathon runner who's generally in peak health, unless I've had a few too many margaritas. But two months ago, I decided to read Proposition 215 to find out just how sick you had to be to obtain marijuana legally.

I made a startling discovery. The state health code listing the conditions for which marijuana can be recommended by a doctor includes migraine right after AIDS, cancer and glaucoma. Every month or so, I get a migraine headache from dehydration or the stress of a deadline. Although I had a hard time believing someone like me might qualify as a medical marijuana patient, there it was in cold print. In the previous few years, some three dozen Amsterdam-style marijuana markets had opened up in San Francisco, their forbidden aromas spilling out from behind closed doors in nearly every neighborhood. I had a perverse desire to sample the wares of my local marijuana shop, the way I shop for a wheel of Brie at my neighborhood fromagerie.

This was all before last Monday's ruling by the United States Supreme Court that users of medical marijuana, in the 11 states that permit it, can be prosecuted by the federal government. But neither the State of California nor the City and County of San Francisco has yet announced any plans to change their medical marijuana policies as a result of the decision.

Even though a doctor's note won't prevent medical marijuana patients from being arrested by the federal authorities, such prosecutions have been extremely rare. To judge by the laissez-faire attitudes that I encountered - from the health department, to sympathetic doctors, to the marijuana emporiums - little seems likely to change for those seeking access to medical marijuana in San Francisco. And gaining access was remarkably easy.

To get in the door of my local marijuana store, the Green Cross, you need a city-issued identification card showing you have a doctor's recommendation for marijuana use. The only person I knew who had ever had one of these "cannabis club cards" was a dialysis patient. But after reading the letter of the law, it looked possible that even I might be entitled to one. I decided to try.

I had just switched health insurance providers to Kaiser Permanente, one of the largest H.M.O.'s in the country. The doctor I made an appointment with had never met me before.

"I have chronic migraines," I told her.

"Mmm hmmm," she said, typing on her computer.

I dropped the bomb. "Will you prescribe me pot?"

She stared at me with a surprised, slightly titillated expression.

"Nobody's ever asked me that before," she said. "I don't know what Kaiser's policy is."

After checking with her colleagues, my doctor told me the unofficial policy is to prescribe marijuana only for "end of life scenarios." My migraines did not qualify.

I called Medicann, a clinic I'd seen advertised in one of the city's alternative newspapers. I was told I needed to come in for a doctor's evaluation, pay $120 and have a copy of the records describing my migraines. I ordered them from Kaiser.

The clinic's anonymous looking storefront was at Sutter and Polk Streets: an area mainly catering to homeless hustlers and their johns. The morning of my appointment, there was a brawl outside, and the streets reeked of urine. Inside, three patients - one with bloodshot eyes, another with long straggly hair and the third wearing a glittering medallion - sat with me in the waiting room. The doctor who called me in had a hoop earring in each ear.

In his windowless office, he asked me if I'd tried prescription migraine drugs, and heartily agreed when I complained they felt "too chemical."

"Most of those drugs are garbage," he declared. He was once a traditional doctor working in a hospital, he said, until he clashed with his supervisor over recommending medical marijuana. He'd recommended medical marijuana to his patients, he told me, after seeing them become dependent on prescription opiates.

"I didn't want to be responsible for turning people into drug addicts," he said passionately, handing me a written recommendation for marijuana. He scoffed at the federal laws and never asked to see my records.

All I needed to do now, the Medicann receptionist told me, was to take my doctor-signed marijuana recommendation to the city's Department of Public Health, and they would issue me my cannabis club card.

I checked the health department Web site and learned that I could take along three people to act as my "primary caregivers." They would get cards entitling them to the same rights and privileges , even though they're not sick. That way, in case I was too infirm to buy my medicine, they could pick it up for me. My real-life primary caregiver, my husband, had failed to grasp the point of my whole experiment, insisting that "pot is basically legal anyway and isn't hard to get." So I took along two good friends instead.

The three of us stood in line inside the health department building for a half hour. When we were eventually called into the back office, a city worker photographed us with a camera festooned with a toy gray mouse wearing a top hat, and said festively, "Look at Smokey!"

A few minutes later, our laminated cards were in our hands. Next to our pictures, they simply read "Patient" and "Caregiver." Our names were left off, to protect us from being identified by federal authorities, it was explained to me at a city government hearing. Some weeks later one of my caregivers and I visited our local club, the Green Cross. It is on a quiet street lined with Victorian homes between the bohemian enclave of the Mission District and the yuppyish Noe Valley neighborhood. We buzzed the doorbell, and a young man with a long ponytail opened the door. We flashed our cards, and he let us in.

Several young men were browsing at a long display case while ambient techno music played. I felt as if I were in a hip clothing boutique.

We checked out the line of glass candy jars full of 50 varieties of marijuana. A cheerful young man behind the counter in a T-shirt that read "SF Ganja" asked,

"First time?"

We nodded, and he offered us a free sample of the baked goods containing marijuana. I selected a vegan brownie.

We paid $40 for a few buds of a cannabis strain called "Thai Princess," which the employee said was the shop's top seller. That also got us a gram of "Trainwreck," and for good measure, a gram of "Super Trainwreck."

Back on the street with a brown paper bag of drugs, I felt naughty, as if I was walking around in only my underwear. I had to keep reminding myself that everything I'd done was on the up-and-up, at least according to state law. The entire process of legally buying marijuana had been shockingly easy. Concerned that the excitement of our first medical cannabis transaction might trigger one of my migraines, my caregiver suggested that we practice some preventive medicine back at my apartment. "Thai Princess" had excellent therapeutic qualities, and I was pain free for the rest of the afternoon.

In fact, our behavior was just what some of the critics of medical marijuana have warned against - that its easy availability opens the door to recreational use and encourages an aura of tolerance, at a time when marijuana abuse is a problem among young people. But I believed that the causes of addiction were more complicated than that.

Now, the fact that I might lose the legal rights I'd only so recently discovered I had was causing me some distress. In fact, I could feel a headache coming on.

Source: New York Times (NY)
Author: Lessley Anderson
Published: June 12, 2005
Copyright: 2005 The New York Times Company
Contact: letters@nytimes.com
Website: http://www.nytimes.com/
Link to article: http://www.cannabisnews.com/news/thread20840.shtml

 

A Register-Guard Editorial
Source: Register-Guard

USA -- The medicinal value of marijuana wouldn't be an issue if it weren't for the Controlled Substances Act of 1970, which assigned marijuana a Schedule I designation. The indefensible classification put marijuana alongside heroin and hallucinogens as a dangerous and addictive drug with no accepted medical use. The Schedule I listing played a key role in Monday's 6-3 Supreme Court decision that federal law trumps state law when it comes to marijuana. But the court was appropriately troubled by the decision's effect on medical marijuana patients.

Writing for the majority, Justice John Paul Stevens noted that the solution could be found when "the voices of voters" are "heard in the halls of Congress."

Unfortunately, Congress is all but deaf when voters' voices mention marijuana. That's why voters in 11 states, including Oregon, used the more responsive state initiative process to give sick people access to medical marijuana.

Monday's ruling makes it clear that without corrective action by Congress, the federal government can arrest and prosecute Americans for using a medicine that has been legally prescribed by a doctor under state law. The decision is a victory for the Bush administration, which views state medical marijuana laws as a threat to long-standing national drug policy.

Solid scientific data confirming the medicinal value of marijuana would be an even greater threat to the draconian federal pot policy. There's a reason for the dearth of independent research on the subject: The government controls the only legal supply of marijuana available for research. The administration isn't much interested in providing scientists with the means to debunk its absolutist position on pot.

That makes marijuana as medicine vulnerable to a Catch-22 criticism from opponents.

"To date, science and research have not determined that smoking marijuana is safe or effective," John Walters, director of National Drug Control Policy, said Monday.

Walters conveniently ignores the formal studies that have been done and the anecdotal reports of hundreds of thousands of medical marijuana patients, all of which leave little doubt of the drug's medicinal value. Marijuana has been shown to relieve nausea, appetite loss, muscle spasms, seizures and chronic pain. It has long been known to reduce the intraocular pressure associated with glaucoma, the leading cause of blindness in the United States.

A more legitimate criticism was raised by the Institute of Medicine in its seminal 1999 report. "Smoked marijuana," the institute noted, "is a crude THC (marijuana's active ingredient) delivery system that also delivers harmful substances." Marijuana smoke contains up to four times as much tar as tobacco, as well as many of the other harmful components of tobacco smoke. The institute's report stated flatly, "There is little future in smoked marijuana as a medically approved medication."

Apart from the serious health issues, smoking pot medicinally will always be seen by opponents as a cover for recreational users, a dangerously contradictory message for children and a Trojan horse for legalization of marijuana. Medical marijuana advocates' interests are best served by the development of safe alternatives to smoking.

One such alternative is the synthetic THC pill Marinol, but many patients say the pill takes effect too slowly and has side effects that aren't present in smoked marijuana.

A more promising alternative is Sativex, a natural liquid marijuana extract developed by a British company that is sprayed into the mouth. The prescription sale of Sativex was approved in Canada on April 19.

But don't expect to see Sativex at your local pharmacy anytime soon. It's the Schedule 1, felony thing. Given the political climate, Food and Drug Administration testing and approval of Sativex is about as likely as an FDA ban on tobacco products.

The real solution is, ironically, contained in a 1988 ruling by the Drug Enforcement Administration's own chief administrative law judge: Move marijuana from Schedule I to Schedule II. Such a designation would continue strict control but also would enable doctors to legally prescribe marijuana, just as they do with the Schedule II drugs morphine and cocaine. It would open the doors to widespread research and development of safe alternatives to smoking. The DEA's brass rejected the ruling out of hand. A court upheld their decision following a challenge in 1994.

Congress has the power to reschedule marijuana through legislation. If lawmakers would listen to the voices of the voters, they'd realize that rescheduling isn't legalization or even decriminalization. It's just compassion and common sense.

Complete Title: It's Up To Congress: Reclassify Marijuana as a Schedule II Drug

Source: Register-Guard, The (OR)
Published: June 10, 2005
Copyright: 2005 The Register-Guard
Contact: rgletters@guardnet.com
Website: http://www.registerguard.com/
Link to article: http://www.cannabisnews.com/news/thread20837.shtml

 

By Daniel N. Abrahamson, Guest Columnist
Source: Los Angeles Daily News

Washington, D.C. -- Legally speaking, the Supreme Court's decision on Monday was unsurprising and broke no new ground. The court, in Gonzales v. Raich, did what most observers predicted: It reaffirmed that federal law-enforcement officials have the power to enforce federal laws banning marijuana possession and cultivation against seriously ill patients who use physician-approved marijuana for medical purposes. In so ruling, the court maintained the legal status quo that has been in place for several decades.

The court also presented an important opportunity for Congress to take action in defense of vulnerable patients.

As a practical matter, the court's decision promises to perpetuate the political standoff, brewing since the mid-1990s, between state and federal governments regarding medical marijuana. Despite the Raich ruling, states remain free to enact and enforce laws permitting sick people to use medical marijuana. Meanwhile, the federal government still has a choice: It can waste taxpayer dollars by going after sick and dying patients or pursue individuals who pose a real danger to society.

In the last eight years, 10 states have enacted statutes permitting seriously ill patients to use physician-approved medical marijuana to relieve their suffering. It is conservatively estimated that at least 100,000 such patients are benefiting from these laws.

The Raich case involved a valiant legal gambit by two California patients, Angel Raich and Diane Monson, to prevent federal law-enforcement officials from seizing their herbal medicine and arresting them for violating federal drug laws. Raich suffers from multiple debilitating conditions, including an inoperable brain tumor, scoliosis, endometriosis and fibromyalgia. She had tried 30 medicines, none of which helped alleviate her pain, before she turned to marijuana as a last resort, and, as her physician states, marijuana has proved to be her only effective analgesic.

Nevertheless, the high court refused to rein in the power of federal police to interfere with her state-sanctioned medicine.

Mounting scientific evidence from researchers around the globe about marijuana's medical efficacy, the continuous outpouring of patient and physician testimonials, and the refusal of Congress to change federal law on this issue are almost certain to energize more states to pass laws that confer state protections on persons who need medical marijuana.

Indeed, even the Supreme Court acknowledged in its Raich decision that the evidence on behalf of medical marijuana should "cast serious doubt" on Congress' decision to keep it illegal under federal law. Along these lines, the U.S. House of Representatives will soon consider a bipartisan amendment authored by Rep. Maurice Hinchey, D-N.Y., and Rep. Dana Rohrabacher, R-Calif., which would prohibit the Justice Department and Drug Enforcement Agency from spending any money on undermining state medical-marijuana laws.

Last year almost 150 representatives signed on to the Hinchey-Rohrabacher amendment, and this year it is poised to pick up more support.

But whether it passes or not, the Raich decision will further motivate state and local officials to devise innovative methods and procedures to help insulate seriously ill individuals from the prying eyes and heavy-handed tactics of federal police. For example, several municipalities have already enacted or are considering ordinances that would prevent local police from sharing information or resources with federal agents about medical-marijuana patients, gardens and dispensaries.

If history is any guide, it appears that federal officials lack either the will or the resources to arrest or prosecute more than a small handful of the tens of thousands of persons currently using medical marijuana around the country, perhaps because federal juries are reluctant to convict sick people for using a medicine that relieves their pain. Of course, even a single federal prosecution of a sick person for using a physician-recommended medication is one too many; but as a practical matter, the average medical-marijuana patient who complies with state law will likely have little to fear from the federal police.

Although the Supreme Court in 2003 let stand a lower court ruling permitting physicians to recommend marijuana to patients under the First Amendment, the Raich decision represents the second time in recent years that the Supreme Court has denied legal relief to medical-marijuana advocates.

But Raich does not spell the end of federal litigation in this area. Other cases involving medical-marijuana patients are awaiting decision in lower federal courts, raising new and important constitutional questions left open by the Raich decision. What is more, states will continue to experiment in expanding state legal protections for patients, perhaps below federal radar, as communities mobilize to reduce the pain and suffering of the seriously ill.

Note: Congress, states, lower courts could heat it up again.

Daniel Abrahamson is the director of legal affairs for the Drug Policy Alliance. -- http://www.drugpolicy.org/

Source: Los Angeles Daily News (CA)
Author: Daniel N. Abrahamson, Guest Columnist
Published: Wednesday, June 08, 2005
Copyright: 2005 Los Angeles Daily News
Website: http://www.dailynews.com/
Contact: josh.kleinbaum@dailynews.com
Link to article: http://cannabisnews.com/news/thread20821.shtml

 

By Clarence Page
Source: Chicago Tribune

Washington, D.C. -- "When I use a word," Humpty Dumpty said in rather a scornful tone in Lewis Carroll's "Through the Looking Glass," "it means just what I choose it to mean--neither more nor less.'" The same might be said by U.S. Supreme Court justices. Take, for example, Gonzales vs. Raich, the high court's medicinal marijuana case.

The commerce clause in Article 1 of the Constitution could hardly be more clear in limiting federal power to commerce "among the several states," not within a state.

But in Gonzales vs. Raich, a 6-3 majority has stretched "commerce" to mean just what they choose it to mean--far enough to let the distant feds, not the close-to-the-people state governments, decide whether ailing residents should be allowed to grow their own medicine under a doctor's care.

In the Senate's heated debate over judicial appointments we have constantly heard conservatives argue that judges should lean toward a modest role for the national government. Over the past decade, a conservative Supreme Court coalition under Chief Justice William Rehnquist has rolled back congressional power and elevated "states' rights" in a series of decisions. Nevertheless, the Supreme Court reasserted federal authority in Gonzales vs. Raich on Monday, even in the 11 states that now permit marijuana when recommended by a doctor.

The people in those 11 states have spoken, and the Supreme Court has told them to shut up.

Justice John Paul Stevens' majority opinion stretched the meaning of "commerce" to include anything done in one state that could have "a substantial effect on interstate commerce." And how does the court define "substantial"? Broadly enough to cover just about anything.

"... Production of the commodity meant for home consumption, be it wheat or marijuana, has a substantial effect on supply and demand in the national market for that commodity," Stevens wrote.

Justice Antonin Scalia, the archest of the high court's arch-conservatives, chimed in, if only to say that Stevens' federal "intrusionism" did not go far enough. "Drugs like marijuana are fungible commodities"; even when "grown at home and possessed for personal use," it is "never more than an instant from the interstate market."

Both opinions sound more like economic theory than day-to-day reality. After all, the medical marijuana market is only a tiny fraction of a state's overall drug traffic.

That very rational point, among others, was made by Justice Clarence Thomas, who cut himself loose from his usual tether to Scalia's world view to raise a clear, compelling and badly needed voice of reason: If the two California women who are the defendants in this case are involved in "interstate commerce," he asked, what in these United States is not "interstate commerce"?

"Respondents Diane Monson and Angel Raich use marijuana that has never been bought or sold, that has never crossed state lines, and that has had no demonstrable effect on the national market for marijuana," Thomas wrote. "If Congress can regulate this under the commerce clause, then it can regulate virtually anything--and the federal government is no longer one of limited and enumerated powers."

In other words, keep your federal hands out of matters that pertain only to a particular state and do not infringe on fundamental human rights.

That human-rights point is particularly significant to those African-Americans who are old enough to remember when "states' rights" was offered as a lame excuse to perpetuate racial segregation laws in the South. The 1954 Brown vs. Board of Education Supreme Court decision properly overruled states' rights that violate fundamental human rights. By contrast, Gonzales vs. Raich ironically overrules states' rights in order to violate a humane right, the right of the sick to treat their own illness. "Our federalist system, properly understood, allows California and a growing number of other states to decide for themselves how to safeguard the health and welfare of their citizens," Thomas writes. Right on.

The good news in Gonzales vs. Raich is that the high court did not overturn any of the existing state medicinal marijuana laws. Stevens' decision also ruled in defiance of Congress and John P. Walters, director of the White House Office of National Drug Control Policy, that marijuana does indeed have "therapeutic value." Stevens suggested that the executive branch might reclassify marijuana for medical purposes or that Congress might allow "the laboratory of the states" to decide this matter for themselves.

In fact, Congress is considering two bills, backed mostly by Democrats and libertarian-leaning Republicans, that could legalize the medicinal use of marijuana at the federal level.

Congress usually kicks such hot-burning issues as marijuana reform over to the courts. This time, the courts have kicked it right back. Congress, as W.C. Fields once said, needs to take the bull by the tail and face the situation. And the public needs to make itself heard.

Clarence Page is a member of the Tribune's editorial board.

Complete Title: Will Congress Have The Guts To Tackle Medical Marijuana?

Source: Chicago Tribune (IL)
Author: Clarence Page
Published: June 8, 2005
Copyright: 2005 Chicago Tribune Company
Contact: ctc-TribLetter@Tribune.com
Website: http://www.chicagotribune.com/
Link to article: http://cannabisnews.com/news/thread20815.shtml