cannabisnews.com: Medical Marijuana: A Supportive Argument





Medical Marijuana: A Supportive Argument
Posted by FoM on May 17, 2001 at 09:33:42 PT
With Daniel Abrahamson 
Source: Washington Post
The Supreme Court ruled Monday that the federal government can shut down California marijuana cooperatives that distribute the drug to people who say they need it to combat the symptoms of AIDS, cancer, multiple sclerosis and other diseases. Daniel Abrahamson, director of legal affairs for the Lindesmith Center-Drug Policy Foundation, is online Tuesday, May 15, at 11 a.m. EDT, to discuss the court's decision and its possible repercussions. The decison is a "tragic departure by the Supreme Court from sound science and good medicine which shows that marijuana is very helpful to certain patients for whom nothing else works," said Abrahamson. 
But he said that "the court's decision has very little practical impact on the day-to-day lives of most patients who need marijuana." Abrahamson oversees litigation, legislative drafting and public education efforts concerning drug policy reform. The Lindesmith Center, created in 1994, is the leading drug policy institute in the U.S. and works to broaden and inform the public debate on drug policy and related issues. The Drug Policy Foundation represents over 25,000 supporters who favor alternatives to the current war on drugs and is the principal membership-based organization advocating drug policy reform. A transcript follows. Editor's Note: Washingtonpost.com moderators retain editorial control over Live Online discussions and choose the most relevant questions for guests and hosts; guests and hosts can decline to answer questions. Washington, D.C.: What are the benefits of using marijuana for these diseases? Daniel Abrahamson: The medical and scientific literature is quite clear that marijuana can help: 1. Reduce nausea associated with chemotherapy, pain medications and other things; 2. Stimulate appetite to counteract wasting disease associated with certain cancers, HIV/AIDS, and other illnesses; 3. Treat pain, particularly neuropathic pain; 4. Reduce or eliminate seizure activity for certain epileptics; 5. Help control muscle spasticity and pain associated with it. For more information, please visit www.drugpolicy.org and click on the medical amicus brief submitted to the Supreme Court in the Medical Marijuana case. The brief discusses in great detail the medical research and findings. Arlington, Va.: What does yesterday's ruling apply to all states and not just California? Daniel Abrahamson: Because the US Supreme Court -- the highest court in the land (as it were) -- was interpreting a federal statute which is national in scope, the ruling applies to all states, not just California where the case arose. Accordingly, the Court declared that Medical Cannabis Dispensaries, wherever they are located in the U.S., are illegal under federal law (the Controlled Substances Act) as that law is presently written. Bowie: How many of the medical benefits of marijuana are exclusive to that drug, i.e. not available from any others? Daniel Abrahamson: In one sense, none of the known medical benefits of marijuana are exclusive to marijuana. That is to say, there are other drugs on the market that address each of the symptoms that marijuana has been shown to be useful for. However, the medical literature and clinical experience (and your own personal experience with medications generally) make clear that some people do not respond at all, or respond well to (or cannot tolerate the side effects of) many or all medications on the market. It is for these persons -- a minority or people, but a significant minority nonetheless -- for whom marijuana is a particularly important option. At bottom, there are tens of thousands of people who suffer serious, debilitating illnesses for whom marijuana provides the most effective treatment b/c conventional medications are unsatisfactory for one reason or another. Washington, DC: How will this ruling affect medical marijuana laws on the state level? Are existing laws on the books in jeopardy? Can other states pursue new laws protecting this form of treatment? Daniel Abrahamson: Yesterday's ruling does NOT affect the state medical marijuana laws that are on the books. Those laws provide state law protections to medical marijuana users, their caregivers and their physicians. Those laws do not purport to change (or be changed by) federal law. Thus, even before yesterday's ruling, medical marijuana users protected by state law were exposed to federal sanctions, b/c marijuana is illegal under federal law. The important point is that it is the STATES, not the federal gov't, that enforces the marijuana laws for low-level, small-time users and dealers. Accordingly, these state medical marijuana laws provide a great deal of protection to patients. And, to repeat, these state laws are not affected by the USSC ruling. Similarly, other states are still free to enact medical marijuana laws that protect patients, caregivers, doctors, even growers / cooperatives from STATE law sanctions. Washington, D.C.: What do you mean, the ruling will have "very little practical impact" on those who need marijuana? How will they be able to get it legally? Daniel Abrahamson: The fact is that most patients who need and use medical marijuana do not have access to, or do not use a Medical Marijuana Dispensary of the type at issue in yesterday's case. Most patients either grow their own mj, have a caregiver who gets the medicine for them, or purchases it on the black market (a dangerous thing to do for a host of reasons). The ruling, however, will have a real and hurtful impact on the few thousand people who do in fact depend on such dispensaries to supply a consistent and safe quantity of medical-grade mj. It is likely, however, that the dispensaries will be pushed underground to operate out of sight of the federal authorities on a smaller scale. Washington, D.C.: How does the ruling affect individual users in terms of growing and using their own plants, not distributing or selling? Daniel Abrahamson: As the concurring opinion by Justices Stevens, Ginsburg and Souter makes clear, yesterday's opinion does not reach the issue of patients growing and using their own plants who might qualify under the medical necessity defense. The case only concerned the cultivation and distribution by third persons. For seriously ill persons, there is a strong argument that if they qualify for medical necessity (which is a pretty high obstacle) there is room in federal law that would permit them to grow and use their own mj. Also, unlikely a jury would convict a seriously ill person. But no patient wants to go through a criminal trial. Woodley Park, D.C.: Hi, I'm a supporter of medical marijuana, but I think one thing that turns off many Americans is that the marijuana is still smoked when used medicinally. No other legitimate medicine is used in such a fashion, and there must be negative side effects on the lungs. It just makes the whole concept look more suspect to average folks. Is there any research going on into developing medicinal marijuana in pill form, or delivery via an inhaler like for asthma? Daniel Abrahamson: Smoking is actually one of the most efficient ways to deliver a drug into the bloodstream, as the lungs provide a quick route for ingestion into the bloodstream. For people seeking immediate relief from pain or nausea, smoking mj is the fastest way to get such relief. For these reasons, inhalers are used for asthma, and doctors used to have patients smoke asthma medicine several decades ago. But because chronic smoking is not good for the lungs, researchers are looking at other delivery mechanisms for medical marijuana that are less harmful, but also fast acting (the Marinol pill, which is synthesized THC -- one of many active compounds found in marijuana) currently on the market is notoriously slow acting) At present, there is research into marijuana inhalers, pills that contain additional ingredients to THC, suppositories and various other methods. Much of the research is taking place abroad, because the US government opposes much of the research that U.S. scientists wish to conduct. Gaithersburg Md.: There was a paper last month in SCIENCE magazine on effects of marijuana and how it curbs the neuronal signal, which in effect when applied to such sensations as increasing hunger and pain relief ... makes a whole lot of sense. When higher people are making decisions for social victims (of cigarette smoke, pollution) who could be dying, and could be using the "last breath" of rights they might have, I wonder if anyone even mentioned the article or are in a habit of looking at such recent scientific finding, without leaning completely on the other side and making decisions for Victims period. Daniel Abrahamson: The latest scientific evidence (but not the Science article which was published after this case was argued) was presented to the Supreme Court. One of the tragic aspects of yesterday's opinion was that it completely ignored the science and departed from teachings and experience of the medical community. To see the scientific information presented to the court, visit www.drugpolicy.org and click on the amicus brief box. Arlington, Va.: You mentioned "medical grade" marijuana. How is that different from what one might buy on the street? Daniel Abrahamson: Medical grade marijuana is typically organically grown and checked for fungispores and other adulterants that could harm patients who have compromised immune systems. In addition, the THC content of the medical grade marijuana is usually known (and patients are given a choice of different THC contents). For mj sold on the street as part of a black market, one can never be sure of its purity or potency. Portland, Ore.: The unanimous ruling by the Supreme Court shows to me how conservative it has become. I would have expected at least one or two justices to stick up for something ordinary people have voted for. I've voted for marijuana legalization here in Oregon in the past (it went down 80-20) and I also voted for the medical marijuana initiative. It seems to me that politically the "medical" approach was much more popular. Is there any political change occurring here? It seems to me that some prominent conservatives have begun to question the drug war and that marijuana would be the first illicit drug to be affected by new political thinking. Daniel Abrahamson: There is real political change afoot. Just within the past 4 years, 8 states have passed medical marijuana laws. 78% of the public thinks patients should have access to medical marijuana. More change at the state level is possible, and if people continue to advocate, probable. Change in Washington, D.C., is always more slow to come. Paradise, California: What will the feds do to people who grow to help other sick people with recommendations? Peace, MedicalMike--- Daniel Abrahamson: Traditionally, federal authorities have not focused on arresting or prosecuting individuals who grow small amounts of marijuana (unless on federal land). THat is the province of state law enforcement. People growing an unusually large number of plants, however, have been targeted by the feds. It is unlikely, but not impossible, that the feds will re-focus their drug war resources to target sick people and their caregivers. The feds have bigger fish to fry in the War on Drugs. Rockville, Md.: Would using the substance a couple times really have lasting effects? (especially if they're terminal) Daniel Abrahamson: Unlikely. Portland, Ore.: Does this ruling extend beyond marijuana? Could other drugs prescribed by physicians be banned because the Federal government is concerned about their illicit use? Daniel Abrahamson: Congress can place any drug it likes on Schedule I of the controlled substances act, effectively banning it from general medical use. It can also remove drugs from Schedule I. The process by which it decides which drugs should be placed on Schedule I (or in any other schedule) is part scientific, but, as in the case of marijuana and ecstasy, mostly political. Worcester, Mass.: Do you really think that THC is necessary to treat the conditions that you mention when as a physician I can prescribe a variety of medications to treat the same purpose? How do you separate those who purely want to smoke a joint from those who MAY benefit from this drug? Daniel Abrahamson: Physicians should always try first-line, prescribable medications for their patients. NOt only do doctors have experience in Rx and administering such meds, but they are of pharmaceutical (assured) quality and are typically covered by medical insurance. But for those patients who do not respond adequately to prescription meds, marijuana may be an important alternative, all things considered. For more information on how, why, and when phsysicians turn to marijuana, I encourage you to check out the legal briefs and physician declarations in the case Conant v. McCaffrey, which are posted on www.drugpolicy.org. The Conant case established the constitutional right of physicians to recommend medical marijuana to those patients who need it. The case was brought after the drug czar threatened to sanction physicians who recommended mj to patients. Stafford, Va.: While I support medical marijuana, I think it's a mistake to blame the Supreme Court for its decision. It's not the role of the courts to write "good policy". That is the role of Congress. While I think the Controlled Substance Act is not a very good law, I do think the Supreme Court's decision to interpret, rather than write, law was the proper approach. Daniel Abrahamson: TO be sure, the controlled substances act is pretty clear that mj is to be illegal under federal law. However, a close reading of the act also makes clear that Congress never addressed the issue of medical necessity when crafting the act. Accordingly, there was a good legal argument (not adopted by the Court) that there was room to read in a medical necessity defense in this case. In any event, the concurring opinion by 3 justices suggests that the Court should do exactly this if there is a case concerning medical use by a patient (vs. distribution by a dispensary). Washington DC: Your group's web site contains articles, written by staff members, in favor of legalizing drugs in this country. Would you consider it fair to view your organization's response to the Supreme Court's as not unbiased? Daniel Abrahamson: The Lindesmith Center-Drug Policy Foundation does not advocate the legalization of drugs -- with one exception: we support the decriminalization (and medicalization) of marijuana. We support mj decrim because the medical, scientific, and social science evidence makes clear that prohibitionist policies regarding marijuana are counterproductive and ineffectual. Indeed, every major blue-ribbon commission to have studied this issue concludes that mj should be decriminalized for personal use. Daniel Abrahamson: Thanks for your questions! For more information about medical marijuana and the Supreme Court case, please visit www.drugpolicy.org Sorry I must log off. Sincerely, Daniel Abrahamson Director of Legal Affairs The Lindesmith Center-Drug Policy Foundation That was our last question today. Thanks to everyone who joined the discussion. Interview with Daniel Abrahamson: Director of Legal Affairs, The Lindesmith Center-Drug Policy FoundationSource: Washington Post (DC) Published: Tuesday, May 15, 2001; 11 a.m. EDT Copyright: 2001 The Washington Post Company Contact: letterstoed washpost.comWebsite: http://www.washingtonpost.comLindesmith Center-Drug Policy Foundationhttp://www.drugpolicy.org/O.C.B.C. Versus The U.S. Government News http://www.freedomtoexhale.com/mj.htmCannabisNews Medical Marijuana Archiveshttp://cannabisnews.com/news/list/medical.shtml 
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