Pubdate: Sat, 17 Mar 2001
Source: National Journal (US)
Section: Health; Vol. 33, No 11
Copyright: 2001 National Journal Group Inc
Contact:  1501 M St., NW #300, Washington, DC 20005
Fax: (202) 833-8069
Website: http://nationaljournal.com/njweekly/
Author: Elisabeth Frater

MEDICAL MARIJUANA: THE SMOLDERING DEBATE

A controversial assault on the nation's war on illegal drugs started in 
1996, when a well-organized and well-funded coalition of drug law reformers 
and grass-roots activists put legalization of "medical marijuana" on the 
ballots in California and Arizona.

Propelled by evidence that marijuana sometimes alleviates the symptoms or 
side effects suffered by some seriously ill people who do not respond to 
conventional medicine, the first two legalization measures proved 
enormously popular, winning 65 percent of the vote in Arizona and 56 
percent in California.

Surprised by the measures' success, the Clinton Administration mobilized 
within days to develop a game plan aimed at defeating similar initiatives 
in other states and preventing the drive to legalize medical marijuana from 
expanding to cover all uses of marijuana. The government's aggressive 
response triggered a high-profile legal clash over whether "medical 
necessity" is a permissible justification for violating federal 
drug-possession laws. That dispute will be heard by the U.S. Supreme Court 
on March 28.

Gen. Barry McCaffrey, who was the Clinton Administration's drug czar in 
1996, recalls: "My own solid judgment was that there were a ... small 
number of people, a few hundred, who were determined to make the use of 
smoked marijuana more tolerated, legal, readily available.... They've got 
money, and they've got energy."

At McCaffrey's urging, representatives of the Justice Department, the Drug 
Enforcement Agency, the Office of National Drug Control Policy, and the 
state governments of California and Arizona met on Nov. 14, 1996, with 
anti-drug interest groups, including the Partnership for a Drug-Free 
America and Community Anti-Drug Coalitions of America. According to 
official notes from that session, the foes of medical marijuana lamented 
that they had been blindsided by "stealth legislation," and they 
characterized the organizers of the initiatives as "using the terminally 
ill as props."

James E. Copple, then-president of Community Anti-Drug Coalitions of 
America, argued at the meeting that the other 48 states needed to be 
protected from medical marijuana propaganda, and he described plans to 
spread a counter-message in seven states.

But Thomas Gede, then a special assistant attorney general of California, 
cautioned the group against taking more-extreme measures, such as seizing 
medical marijuana or arresting those who distributed it. He said he feared 
potential government liability if ill people suffered or died because they 
could not receive the medical marijuana approved by their states. DEA 
officials chimed in to warn that the federal court system would "grind ... 
to a halt" if it were flooded with relatively petty marijuana arrests.

Despite federal efforts to counter it, the medical marijuana cause 
continued to win resounding victories at the state level: By 2000, ballot 
initiatives legalizing the medical use of marijuana had easily passed in 
Alaska, Colorado, Nevada, Oregon, Maine, and Washington. Also in 2000, 
Hawaii's state Legislature became the first to approve medical marijuana.

Yet, state-level medical marijuana measures have proven to be imperfect 
vehicles for their cause, because they don't specify how the marijuana can 
wend its way from growers or suppliers to patients without breaking federal 
law. Cooperatives have been created to dispense medical marijuana in 
various forms, but some, including the Oakland Cannabis Buyers' Cooperative 
in California, have been targeted by the federal lawsuit intended to shut 
them down.

Later this month, the U.S. Supreme Court will hear arguments in United 
States vs. Oakland Cannabis Buyers' Cooperative, the federal government's 
lawsuit to stop what it considers to be the illegal sale and distribution 
of marijuana by California clubs and cooperatives.

The Oakland cooperative is under court order to stop dispensing marijuana 
while the case is pending. Now the cooperative dispenses only advice and 
good wishes. Jeffrey Jones, its executive director, says: "We are important 
to the social and beneficial atmosphere that these patients need, to keep 
on top of their condition and ... not give up on their life-(unlike) the 
cold shoulder and the indifferent hand that the federal government has 
offered them."

The perceived threat posed by cannabis cooperatives is not that there are 
too many for the feds to suppress. According to the National Organization 
for the Reform of Marijuana Laws, there are only 30 to 40 such groups in 
the country. Instead, federal officials are acting out of the conviction, 
shared by anti-drug groups, that medical marijuana is dangerous in itself- 
and also is the stalking horse for efforts to legalize all marijuana use.

As Betty Sembler, founder of the Drug-Free America Foundation in St. 
Petersburg, Fla., puts it: "First of all, I don't call it medicinal 
marijuana, because there is no such thing. Marijuana is medical excuse 
marijuana. That's all it is. The pro-drug lobby is trying to use it to say 
it's a natural thing to do, to burn your lungs, ruin your mind.... It's 
just part of a marketing agenda."

Timothy Lynch, director of the criminal justice program for the libertarian 
Cato Institute, says, "Medical marijuana represents the first step in the 
direction of de-escalating the war" on drugs.

Still, given the evident public support for medical marijuana, why has the 
government continued to fight it? Eric E. Sterling, president of the 
Criminal Justice Policy Foundation, thinks one reason is that the issue 
creates a tug-of-war "between the conservative viewpoint of traditional 
values and those who reject traditional values." In his view, "The war on 
drugs is not only a policy matter, it is a crusade."

Congressional Republicans were among those pressuring federal drug fighters 
to combat medical marijuana. In October 1997, McCaffrey was summoned to 
testify before the House crime subcommittee chaired by then-Rep. Bill 
McCollum, R-Fla., who said he was worried about a possible medical 
marijuana initiative in his state and "the potential consequences of a 
shift in public policy toward marijuana legalization." Rep. Asa Hutchinson, 
R- Ark., sternly ordered McCaffrey "to be more engaged in the battle."

R. Keith Stroup, the founder and executive director of the National 
Organization for the Reform of Marijuana Laws, says that he thinks "the 
Republican (congressional) leadership some time ago chose to make its 
opposition to the medical use of marijuana a major plank in their anti-drug 
war...." Stroup recalls that in 1981, McCollum and then-Rep. Newt Gingrich, 
R- Ga., co-sponsored a bill to allow the therapeutic use of marijuana in 
situations involving life-threatening illnesses.

"Yet," Stroup said, "years later, when the war on drugs is running strong 
and the Republicans are trying to take advantage of it, they actually led 
the charge against medical marijuana. Nothing had changed ...  except that 
the Republicans had taken a particular strategic position."

However, it was a Democratic Administration whose drug czar and Attorney 
General actually challenged the marijuana cooperatives.

Former drug czar McCaffrey denies that obliterating medical marijuana was a 
personal crusade for him and says that he considered it a trifling issue, 
compared with other narcotics problems. He adds that he viewed the medical 
marijuana conflict largely as a medical matter that should be decided in 
the "forum of science and medicine."

Many anti-drug organizations agree with McCaffrey's view. For example, 
Howard Simon, spokesman for Partnership for a Drug- Free America, says: 
"Voters should not circumvent recognized scientific and medical processes 
by deciding what constitutes safe and effective medicine via the ballot 
box. Let's not politicize it. Let's not emotionalize it.... Let's let the 
scientists and researchers give us the answer-the same way the (Food and 
Drug Administration) would look at any other proposed medication."

In January 1997, McCaffrey commissioned the National Academy of Sciences' 
Institute of Medicine to assess the potential health benefits and risks of 
marijuana and THC, the primary psychoactive ingredient in marijuana. Both 
sides found some support for their views in the NAS report, which was 
released in March 1999.

Pro-marijuana groups embraced the researchers' conclusion that "there are 
some limited circumstances in which we recommend smoking marijuana for 
medical uses." The report found that marijuana has "potential therapeutic 
value" when used for pain relief, control of chemotherapy-induced nausea, 
and appetite stimulation in AIDS patients.

The government latched onto another of the report's conclusions: "Although 
marijuana smoke delivers THC and other cannabinoids to the body, it also 
delivers harmful substances, including most of those found in tobacco 
smoke." The American Medical Association, which is reviewing its position, 
recommends "adequate and well-controlled studies of smoked marijuana" and 
urges the National Institutes of Health to develop smoke-free methods of 
administering marijuana to patients.

According to a March 1999 Gallup Poll, although 69 percent of American 
adults say they oppose the general decriminalization of marijuana, 73 
percent favor making marijuana "legally available for doctors to prescribe 
in order to reduce pain and suffering."

Most observers doubt that the outcome of the medical marijuana case now 
before the Supreme Court will provide the final word on the larger 
controversy. Sterling predicts that public opinion will eventually force 
the federal government to "change its position, over the objections of DEA 
and the Justice Department."

Sterling concluded: "The American people understand that making marijuana 
available to sick people to relieve their conditions is nothing like 
legalizing marijuana for other kinds of uses.... (Medical marijuana) is not 
going to drive a stake into the heart of law enforcement, as some tend to 
exaggerate."
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