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Medical Marijuana

February 2013

Why Do We Support Medical Marijuana? One of the most egregious outcomes of marijuana prohibition is that many seriously ill people cannot legally access the medicine that works best for them. For many people, medical marijuana is the only medicine that relieves their pain and suffering, or treats symptoms of their medical condition, without debilitating side effects. Marijuana has been shown to alleviate symptoms of a broad variety of serious medical conditions including cancer, AIDS, multiple sclerosis and glaucoma, and is often an effective alternative to synthetic painkillers. The Drug Policy Alliance played a primary role in the passage of medical marijuana laws in nine states, starting with Californias Proposition 215 in 1996. We are committed to increasing the number of states with laws that allow for medical use under state law, supporting and improving existing state medical marijuana programs, protecting medical marijuana patients from criminal sanction and discrimination, and ending the federal ban on medical marijuana. Medical Marijuana Today For more than a decade, polls have consistently shown public support for medical marijuana between 70 and 80 percent. Eighteen states, and the District of Columbia, have passed laws legalizing the use of medical marijuana for qualifying patients under state law. Eleven did so through ballot initiative. These were: Alaska (58% voter approval), Arizona (65%), California (56%), Colorado (54%), Maine (61%), Massachusetts (63% ), Michigan (63%), Montana (62%), Nevada (65%), Oregon (55%) and Washington (59%). In addition, over the past twelve years, Connecticut, Delaware, Hawaii, New Jersey, New Mexico, Rhode Island and Vermont have passed medical marijuana laws through the state legislative process.

Medical Marijuana is Legal in 18 States & D.C.

While state medical marijuana programs differ from one another in significant ways, most are tightly controlled programs regulated by the state departments of public health. All but one of these jurisdictions issue identification cards to patients who provide their doctors' recommendation to a state or county agency.i These identification cards allow law enforcement to easily determine who is a valid medical marijuana patient. Eleven jurisdictions Arizona, Colorado, Connecticut, Delaware, Maine, Massachusetts, New Jersey, New Mexico, Rhode Island, Vermont and the District of Columbia have laws providing for state-regulated and licensed centers that produce and dispense medical marijuana to patients.ii California is unique in that it allows for local control of medical marijuana rather than relying on statewide regulations of production and distribution. Safety and Efficacy of Medical Marijuana Marijuanas medicinal benefits are incontrovertible, now proven by decades of clinical research. In February 2010, the University of California Center for

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Medicinal Cannabis Research released a report of its findings after a decade of randomized, double-blind, placebo-controlled clinical trials on the medical utility of inhaled marijuana. These trials utilized the gold standard clinical trial design employed by the FDA. The studies concluded that marijuana should be a first line treatment for patients with painful neuropathy and other serious and debilitating symptoms, who often do not respond to other available medications.iii Numerous peer-reviewed, controlled studies of smoked marijuana, published in highly respected and credible medical journals, have confirmed the Centers research. iv In 1999, the White House commissioned the Institute of Medicine of the National Academy of Sciences to conduct a two-year review of the scientific data then available with respect to potential benefits of medical marijuana. The study team found substantial consensus among experts in the relevant disciplines on the scientific evidence about potential medical uses of marijuana. It concluded that, nausea, appetite loss, pain and anxietyall can be mitigated by marijuana. The study team did not exclude smoked marijuana from its conclusions, noting instead that there are even some limited circumstances in which we recommend smoking marijuana for medical use.v Federal Government Obstruction The federal government continues to impede the passage and implementation of state medical marijuana laws. The medical use of marijuana remains illegal under federal law, and patients in states without medical marijuana laws do not have any legal access at all. Even in states where medical marijuana laws exist, patients and providers are vulnerable to arrest and interference from federal law enforcement. Under our federalist system of government, there are independent state and federal laws regarding marijuana. A state may choose to pass laws making the use of medical marijuana legal under state law. Under such a law, states do not arrest or prosecute patients authorized to use medical marijuana. However, the federal government retains its ability to arrest and prosecute medical marijuana patients under federal law even if their actions are legal under state law. Virtually all marijuana possession arrests in the U.S. are made under state law, so changing the state law to allow patients to use medical marijuana has the practical effect of protecting the vast majority of medical marijuana patients from arrest. Since states are not required to prosecute people for engaging in

activities prohibited by federal law, passing legislation removing state law penalties for marijuana does not put a state in violation of federal law. Since 1996, when California passed the first effective medical marijuana law, none of the states medical marijuana laws have been challenged directly in court by the federal government. Marijuana is the only Schedule I drug that the DEA prohibits from being produced by private laboratories for scientific research. While there is a plethora of scientific research establishing marijuana's safety and efficacy, the National Institute on Drug Abuse (NIDA) and Drug Enforcement Administration (DEA) have effectively blocked the standard Food and Drug Administration (FDA) development process that would allow for the marijuana plant to be brought to market as a prescription medicine. Although DEA has licensed multiple privately-funded manufacturers of all other Schedule I drugs, it permits just one facility operated by NIDA to supply marijuana to scientists. NIDA has refused to provide marijuana for three FDAapproved studies, including a study approved by the FDA last year that would have examined medical marijuana for veterans suffering from post-traumatic stress disorder (PTSD). The DEA and NIDA have successfully created a Catch-22 for patients, doctors and scientists by denying that marijuana is a medicine because it is not approved by the FDA, while simultaneously obstructing the very research that would be required for FDA to approve marijuana as a medicine.

Washington state does not have an ID card program. The laws in Arizona, New Mexico, Rhode Island, Colorado, New Jersey, Maine, Massachusetts, Delaware, Vermont, and the District of Columbia provide for licensed centers to produce and distribute marijuana. Connecticut will also regulate and license centers to distribute marijuana to qualifying patients. California has collectives and cooperatives for patients who grow and dispense together, but they are not state-licensed. iii California Center for Medicinal Cannabis Research, Report to the Legislature & Governor of the State of California (2010) http://www.cmcr.ucsd.edu/images/pdfs/CMCR_REPORT_FE B17.pdf. iv See, for example, Igor Grant et al., Medical Marijuana: Clearing Away the Smoke, The Open Neurology Journal 6 (2012): 1825, doi:10.2174/1874205X01206010018. v Janet E. Joy, Stanley J. Watson, Jr., and John A. Benson, Jr., Marijuana and Medicine: Assessing the Science Base (Washington, D.C.: Institute of Medicine, 1999).
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