Medical Marijuana: The Drug Czar is Wrong (Again)

By Bruce Mirken November 11, 2009.

In its official response to the AMA’s recent call for a review of marijuana’s status as a Schedule I drug (barring any medical use) under federal law, the White House Office of National Drug Control Policy stated that it would defer to “the FDA’s judgment that the raw marijuana plant cannot meet the standards for identity, strength, quality, purity, packaging and labeling required of medicine.”

While we’re not used to factual accuracy from ONDCP, in this case they’re wrong not once, but twice.

First, there is absolutely no reason that plant medicines can’t be standardized and controlled for purity and potency. Indeed, the Netherlands has been doing just that for years, with medical marijuana distributed in Dutch pharmacies that is “of pharmaceutical quality and complies with the strictest requirements,” according to the Dutch government.

Second, the FDA has never said that a natural plant product can’t be a medicine. Indeed the agency has a lengthy “Guidance for Industry: Botanical Drug Products,” specifically designed to aid developers of plant medicines. The document not only doesn’t rule out plants as medicines, it even states, “In the initial stage of clinical studies of a botanical drug, it is generally not necessary to identify the active constituents or other biological markers or to have a chemical identification and assay for a particular constituent or marker.” Given that the active components of marijuana are already well-known and extensively researched, marijuana is well ahead of where the FDA says plant products need to be to start the process of seeking FDA licensing.

Yes, the FDA did put out a press release in 2006 saying that “smoked marijuana” had not been shown to be a safe and effective medicine. That statement was utterly unscientific, as we pointed out at the time, but it was absolutely not a declaration that the plant could never be a medicine.



Beware the Medicalization of Marijuana

By Russ Belville of NORML (6.21.09):

DSCN2960I’ve always said that medical marijuana is a beautiful thing.  If I believe that all people have a right to use cannabis, then of course sick people have the same right and should be given the first place in line.

I’ve also said that I hate the line “I’m a patient, not a criminal” because that defines me, the healthy person, as a criminal.  I cannot accept that a medical marijuana user sharing a joint with me equals a “patient” and a “criminal”.  It’s the same joint, so how is my relative healthiness a crime?

Medical marijuana is a double-edged sword to me.  It has been invaluable in opening up people’s minds about cannabis and its uses.  It has afforded the kind of political victories for legalization that no other strategy has (and sorry, medical folks who dislike “legalizers”, medical marijuana is legalization.)  It has, without a doubt, saved tens of thousands of lives and made hundreds of thousands of lives more bearable.

However, I fear that the medical marijuana strategy may have outlived its usefulness.  The medical marijuana bills this year in Minnesota, New Jersey, New York, New Hampshire, and now an Arizona initiative are becoming more restrictive.  After a dozen years of medical marijuana success, defined as “the sky didn’t fall when we legalized marijuana for sick people”, bills and initiatives should be getting more relaxed, not stricter; more inclusive, not less; and more conditions covered, not fewer.  With polls consistently showing mainstream support increasing in states with medical marijuana and holding steady in the states without, medical marijuana bills and initiatives should be getting better, not worse.

What I fear is that the public’s mindset is moving from “marijuana is a deadly addictive gateway drug whose users should be punished” to “marijuana is a powerful medicine that should be used only under strict controls and supervision”.  The most recent bills take away the right of a patient to grow their own medicine, substituting instead requirements that medicine come only from dispensaries over which the state maintains a monopoly.  They’ve pared down the list of “qualifying conditions” to the point where only the gravest ill, the terminal cases with less than six month to live, who’ve tried and had no success with all the other pharmaceutical drugs, only they have any access.  This upcoming Arizona initiative will even electronically track how much medical cannabis a patient purchases and require criminal background checks and fingerprinting that will be forwarded to the FBI!

As fewer and fewer patients qualify for medical cannabis under new, tighter laws, pharmaceutical companies continue to derive and patent cannabinoid compounds and prepare them for dose-regulated delivery by spray, inhaler, cream, and pill.  They’ve used their lobbying power for decades to oppose nature’s finest medicine, the biggest threat to their market for benzodiazepenes, NSAIDs, and opioids, because they couldn’t slap a bar code and a 250,000% markup on pot.  Soon they will be able to provide all these patients with all the benefits of medical cannabis, but without the pesky “high” and the ability to thwart their profits by growing it themselves.

(Huffington Post) According to USA Today in 2005, there were 1,274 registered pharmaceutical lobbyists in Washington, D.C. — more than two for every member of Congress. In 2003, $143 million was spent on lobbying activities by the Pharmaceutical industry. There are more lobbyists from pharmaceutical than any other industry trying to bend legislators’ ears.

This is big business, and that means that your health care is not in the hands of people who really want to help you, but in the hands of people who view you as a market.

Caveat emptor. You expect to beware in a used car lot. But buying a lemon auto is not nearly as likely to kill you as prescription medicine. Approximately 43,000 people died in car crashes in the U.S. in 2004, and the rate has been declining every year since. 100,000 people die in the U.S. every year from properly prescribed and properly administered prescription drugs, according to the Journal of the American Medical Association. The Florida Medical Examiners concluded that three times more people die from prescription medicine as die from illegal drugs.

What I fear is dispensaries becoming pharmacies and cannabis becoming another pharmaceutical and those lobbyists turning that $143 million toward enacting horribly restrictive medical marijuana laws that preserve their profits by banning home growing.  Medical marijuana is beginning to steer marijuana law reform toward treating cannabis like codeine and away from treating cannabis like Coors Light.  Whether you and I are busted because we’re “dopers smoking an illegal drug” or because we’re “recreational prescription cannabis abusers”, we’re still busted.

The beauty of medical marijuana is that people can cheaply and easily care for themselves.  That’s also threatening to the health care model as it is run today, because cannabis violates that need for the middlemen and bureaucracy to receive treatment.  I don’t need to see the doctor every so often to have him re-approve my prescription and I don’t need to see the pharmacist to fill it up.  I can grow it and use it when I need it.  It can’t kill me so I can’t take too much.  It can’t addict me so I don’t need supervision.  It doesn’t alter my perceptions and actions to the point that I need strict regulation.  (In a sense I liken it to Martin Luther nailing up his protest of the Catholic Church to the church door on Halloween of 1517 – we don’t need intermediaries, we can find our salvation ourselves!)

But now we’re seeing these new bills and initiatives requiring more visits with the doctor, requiring the cannabis to come from dispensaries, and strictly documenting how much is to be used.  Cannabis is being forced to fit into the paradigm of health care for profit with all the intermediaries, bureaucracy, markups, and restrictions.  Once it is locked into the health insurance – pharmaceutical – medical complex, legalization for you and me will be farther away than ever.

This is why I think the next eighteen months are crucial in marijuana law reform.  We’ve never had higher support for legalization, in part due to the economy.  A state needs to break through with legalization for you and me, before the economy begins to recover, before cannabis pharmaceuticals gain widespread approval, before a half-dozen more states enact increasingly restrictive medical marijuana laws, and before cannabis becomes so ingrained in the public’s mind as a medicine that we can’t get them to accept it as a social intoxicant.