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Psychiatric Times. Vol. 27 No. 1
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NEWS 

The Past, Present, and Future of Medical Marijuana in the United States

By John Thomas, JD, LLM, MPH | January 6, 2010
New Haven, Connecticut
Professor Thomas is a former litigator who teaches law and medicine, advanced law and medicine, civil procedure, and commercial law at the Quinnipiac University College of Law. His publication topics range from health policy to mental health treatment to acoustic music. He is an accomplished fingerstyle guitarist who has performed at regional festivals, on live radio, and in clubs, coffee houses, and bookstores in the New Haven, Conn, area.

The federal Controlled Substances Act

One of Richard Nixon’s first significant acts as president was to sign into law the Controlled Substances Act of 1970 (CSA).12 With a calculus incorporating variables of medicinal value, potential for abuse, and psychological and physical effect, the act allocated regulated substances into 5 schedules. Congress placed marijuana, along with heroin, ecstasy, LSD, GHB, and peyote, in Schedule I, the only category that prohibits any use, medicinal or not. Drugs like cocaine, codeine(Drug information on codeine), OxyContin, and methamphetamine landed in the less restrictive Schedule II, which permits prescription-based medical use.

Congress placed marijuana in Schedule I temporarily, pending reconsideration in light of the forthcoming report of the National Commission on Marijuana and Drug Abuse.13 The study group, which Nixon commissioned and most of whose members he appointed, recommended decriminalizing “possession in private of marihuana for personal use” and “distribution in private of small amounts of marihuana . . . not involving a profit.” Audiotapes released 30 years later revealed a livid President Nixon who demanded that, despite the report, his administration issue “a goddamn strong statement on marijuana.”14 The president added an anti-Semitic attack against advocates of decriminalization: “You know it’s a funny thing. Every one of the bastards that are out for legalizing marijuana is Jewish. . . . I suppose it’s because most of them are psychiatrists, you know, there’s so many, all the greatest psychiatrists are Jewish.”

President Nixon prevailed, marijuana stayed in Schedule I, and there it remains to this day.

The state response

In 1996, with the passage of Proposition 215, the Compassionate Use Act, California became the first state to challenge the CSA.15 The Compassionate Use Act provided that neither a patient, a “patient’s primary caregiver,” nor a physician may be prosecuted or sanctioned for “the use of marijuana in the treatment of cancer, anorexia, AIDS, chronic pain, spasticity, glaucoma, arthritis, migraine, or any other illness for which marijuana provides relief.”

Following California’s lead, a dozen states—Alaska, Colorado, Hawaii, Maine, Michigan, Montana, Nevada, New Mexico, Oregon, Rhode Island, Vermont, and Washington—enacted laws permitting residents to possess, use, and cultivate marijuana for medical purposes.16

The Supreme Court: Gonzales v Raich17

The litigation that led to the triumph of the CSA over state medical marijuana laws began in August 2002 when federal Drug Enforcement Administration officers and county deputy sheriffs jointly raided the home of a California woman who was cultivating and using marijuana in accordance with the Compassionate Use Act. “[A]fter a 3-hour standoff” with the county deputies, the federal agents seized and destroyed the woman’s marijuana plants. She and others brought suit in federal court to enjoin the application of the CSA on the ground that it infringed on her constitutional rights.

The medical user lost at the trial level but prevailed on appeal when the US Court of Appeals held that the federal power to regulate commerce and, thus, drug use, did not reach state-authorized medical use: “this limited use is clearly distinct from the broader illicit drug market . . . insofar as the medicinal marijuana at issue in this case is not intended for, nor does it enter, the stream of commerce.”

On June 5, 2005, in a 6 to 3 vote, the US Supreme Court reversed the judgment, invalidating the California law, and embracing an expansive view of the power of the federal government and the reach of the CSA: “The CSA designates marijuana as contraband for any purpose; in fact, by characterizing marijuana as a Schedule I drug, Congress expressly found that the drug has no acceptable medical uses.”

Thus was the status of medical marijuana, authorized by a quarter of the states but banned by federal law, until the Justice Department’s recent memorandum.

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by orison squirrel | February 08, 2011 5:47 AM EST

"We have spent over a trillion dollars trying to eradicate the world's most beneficial plant off the face of the earth. Imagine what a better world this would be if that money had been spent on treatment, education and studying the medical benefits of marijuana."
-- Steve Hager - High Times Editor (1988 - 2003)




"But at this point, I'd be in favor of legalization. I wouldn't encourage anybody to smoke any substances. But I don't think it should be stigmatized as an illegal substance. Tobacco smoking causes far more harm. And in terms of an intoxicant, alcohol causes far more harm."
~ Donald Tashkin,
National Institute on Drug Abuse


I left Western Pa in the mid 70's and it was always good pot, and with the Steelers stitching up the generation gap a tad, and Leary overturning the Marijuana Tax Act. It was mostly overlooked as a problem and cops would usually confiscate it and thats it. They had dry counties for booze, but medicinally they could treat it as they do drug stores. State stores sell the hard booze, or did then. Its all based on Nixon's lies and the lies are getting ridulous and repeatative. It's the Commonwealth with the Whiskey Rebellion. I think its ripe for a reality check. Though fossil fools, drugs, booze, prisons, cops and rehabs will always hide behind kids, perpetuating this farce for profits.



Commonwealth
Thus commonwealth originally meant a state or nation-state governed for the common good as opposed to an authoritarian state governed for the benefit of a given class of owners.

by Mary Lynn Mathre | January 25, 2010 10:01 AM EST

As noted in the article above - cannabis never belonged in Schedule I, yet it remains in this forbidden category. NIDA has sponsored countless studies to support the "reefer madness" about the dangers of cannabis, but by 1998 cannabis researchers began to learn about the endocannabinoid system. This discovery is helping us understand why it is so safe and why it has such a wide variety of indications for use. With the prohibition, illicit users/dealers search for ways to make it more potent (as in mooonshine during the prohibition)and now studies indicate that it may be the high THC content and very low CBD content found in the skunk variety that lead to psychotic reactions. Cannabidiol or CBD is not psychoactive and helps modulate the THC found in natural cannabis. This may explain why many patients dislike dronabinol (synthetic THC in sesame oil) - THC is responsible for the high and too much may not be a good thing. Learn more about the science and visit www.medicalcannabis.com - patients need this herbal medicine now.

by Art Zwerling | January 24, 2010 12:36 PM EST

I believe there are scientific inquiry issues that need to be a resolved before we decriminalize marijuana. Certainly maintaining cannabis preperations in DEA Scedule 1 is sheer insanity. As a starting place we may want to consider placing established therapeutic cannabinoids like dronabinol, nabilone and Sativex (when and if released in the US) in a less restrictive category. Given the incredibly complex pharmacognosy and pharmacology of crude cannabis preperations, I'm not sure that making medical marijuana freely available is well advised until we have more well controlled prospective studies clearly demonstrating it's therapeutic advantages over available cannabinoid preperations that utilize a less deleterious route of administration with a standardized preparation of predictable potency. Certainly we can do better than to leave folks that have a documented medical need for cannabinoids out in the grey zone of illegal but not prosecuted! Art Zwerling





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