Medical Marijuana in Focus

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In the July 28th issue of The New Yorker you’ll find an entertaining story by David Samuels that explores the economy of pot in California, where medical marijuana has been legal since 1996. Focusing on the supply and distribution chains that help to get pot in the hands of patients, Samuels weaves a colorful yarn, but one that focuses heavily—and somewhat derisively—on the personalities involved. Given the author’s emphasis on the stereotypical stonerdom surrounding legalization, the casual reader may come away thinking that medical marijuana is just another hippie cause, a 60s-style cultural crusade rather than a question of health care. But that’s not the case. 

Aging Hippies

Samuels’ account of the medical marijuana industry boasts quite a cast. There’s “Captain Blue,” a middle-aged grower with “black and greasy hair” and ill-fitting tee-shirts that “expose his round belly.” He sells weed to dispensaries that supply medicinal marijuana. Then there’s “Lily,” who transports ganja “from Northern California to Blue’s apartment” in the trunk of her car, and a woman named “Cindy 99” who runs a dispensary and who looks like an “adolescent boy’s fantasy of his best friend’s hot older sister.” Finally let’s not forget “Dr. Dean,” the free-wheeling M.D. who regularly prescribes marijuana thanks to a watershed night at his friends’ where he was introduced to marijuana via spiked lollipops and brownies. “It was like Amsterdam,” he dreamily tells Samuels.

If these sound like the characters from a teen stoner movie, that’s certainly the way that they’re represented by Samuels. With such an emphasis on the weed enthusiasts, it’s perhaps unsurprising that the author’s big conclusion about medical marijuana is that it’s just another way to keep the pseudo-subversive indulgences of the 1960s alive. “The legalization of medical marijuana has allowed for the illusion that farming pot can provide opportunities for travel and cool art projects and personal growth,” says Samuels. He then concludes that for aging hippies, “growing ganja lets you feel that you’re still living on the edge,” particularly if you’re a washed-up, wannabe political radical.   

This seems to me a woefully incomplete analysis of the real issues
surrounding medical marijuana. Say what you will about the people who
are pulled into the orbit of marijuana trade, but the fact is that the
legalization of medical marijuana is about a lot more than full
employment for hippies.

Samuels does give us a moment’s insight into what selling medical
marijuana is all about: “Cindy estimated that forty per cent of her
clients suffer from serious illnesses such as cancer, AIDS, glaucoma,
epilepsy, and M.S. The rest have ailments like anxiety, sleeplessness,
A.D.D., and assorted pains.

“Like many other dispensary owners I spoke with," notes Samuels, "Cindy
derives particular satisfaction from providing medication to people who
suffer from chronic diseases. Although she suspects that there is
nothing seriously wrong with many of the young men who come in to buy
an eighth of L.A. Confidential, she doesn’t regard marijuana as a
harmful drug when compared with Xanax, Valium, Prozac, and other pills
that are commonly prescribed by physicians to treat vague complaints of
anxiety or dysphoria.”  But then we’re right back to local color: “The
day I was there, [Cindy 99] wore a tight sleeveless blue T-shirt with a
gilt-winged emblem of a flying horse.”

Medical Issues—What the Candidates Say       

If you’re interested in the serious story behind medical marijuana,
you’ll find there’s a good deal of medical research showing that
marijuana and medication derived from the main psychoactive ingredient
in cannabis, tetrahydrocannabinol (THC), have useful therapeutic
properties. Among the most definitively proven uses of THC is as an
appetite stimulant and antiemetic (i.e. a drug used to combat nausea
and vomiting). According to a February report
from the American College of Physicians (ACP), “clinical trials have
demonstrated that both oral and smoked marijuana stimulate appetite,
increase caloric intake, and result in weight gain among patients
experiencing” involuntary weight loss that can be associated with AIDS.
It can also help to relieve the “nausea and vomiting associated with
chemotherapy for patients who fail to respond to other antiemetics,”
both on its own and as part of a broader drug cocktail. In fact, the
ACP notes that “research has also found that administration of THC
along with another antiemetic was more effective that [other
antiemetics] alone.”

In fact, in one study, 97 percent of HIV-positive patients who used
cannabis reported improved appetite and 93 percent said that the
cannabis helped to reduce nausea. Further, 94 percent reported that the
substance reduced muscle pain, and 90 percent said the same regarding
nerve pain. Indeed, one 2007 study
in the medical journal Neurology found that patients who smoked
marijuana reported a decrease of 34 percent in bodily pain associated
with HIV, versus a reduction of just 17 percent in patients who took a
placebo.  The ACP also notes that smoked marijuana and oral THC
provides “relief of spasticity, pain, and tremor in some patients with
multiple sclerosis (MS), spinal cord injuries, or other trauma.”

Thanks to research such as this, medical marijuana has been legalized,
to varying degrees, in 12 states (Alaska, Colorado, California, Hawaii,
Maine, Maryland, Nevada, New Mexico, Oregon, Rhode Island, Vermont, and
Washington), making it an honest-to-goodness political issue. Indeed,
medical marijuana has become relevant enough that presidential
candidates have been weighing in on this issue throughout the campaign
season.

In March, Barack Obama came out in favor
of a more “practical view” of medical marijuana, saying that “if it’s
an issue of doctors prescribing medical marijuana as a treatment for
glaucoma or as a cancer treatment, I think that should be appropriate
because there really is no difference between that and a doctor
prescribing morphine or anything else”

One related issue, which Samuels does in fact touch on, is the issue of federal raids.
Marijuana is still illegal, in all forms, under federal laws, even if
states allow it—which means that the Drug Enforcement Administration
can still raid providers and users, even if they’re operating in
accordance with state laws. Obama says that these raids won’t continue
in his administration, a sentiment that Hillary Clinton echoed when she
was a candidate.

Conservatives have been, predictably, more hostile toward medical
marijuana: John McCain called  cannabis a “gateway drug” and Mitt
Romney wanted to keep all marijuana illegal because “because pain
management is available from other sources.” This idea—that legalizing
medical marijuana opens an unnecessary Pandora’s box of drug abuse—just
doesn’t hold water. The legalization of medical marijuana in California
has not led to increased weed use amongst teenagers. In fact, research
from the University of Albany shows that there’s been a 47 percent
reduction in California teenagers’ self-reporting of marijuana smoking
since medical marijuana was legalized. The same trend has held true in
other states where medical marijuana has become legal: in Washington
state, there has been a 25 to 50 percent reduction in self-reported use
since legalization, and Hawaii has seen a 38 percent decrease.

Clearly, there’s no shortage of real, substantive issues to discuss
when it comes to medical marijuana. Is it a medically valid form of
therapy? Should we be pursuing more research? Evidence strongly
suggests that the answer is yes to both questions. Given this, it’s
frustrating to read a 12,000 word piece that culminates with a ganja
grower declaring that “you’re still subverting the Man. And you’re
getting people high.” Reducing medical marijuana to stoner culture does
the issue a real disservice.

Obviously The New Yorker doesn’t have some formal obligation to publish
‘big-picture’ pieces, nor is it a journal of medicine or policy. But
given how much there is to say about medical marijuana as a health
issue—and how the case for it is much stronger than you might think—it
seems a waste to focus on the tics and philosophies of pot dealers.

When it comes to medical marijuana, this just isn’t the real story.

20 thoughts on “Medical Marijuana in Focus”

  2. Truth being somewhat stranger than fiction, I am told that the custom in Europe is to mix marijuana with tobacco, rather than the American custom of smoking pure marijuana.
    While the application is not necessarily medical, I find it ironic that Amsterdam “coffeehouses” are under orders to ban smokers, under EU regulations — if their smoking product contains tobacco.
    For the record, I once made the mistake of going into an Amsterdam coffeehouse because I wanted a cup of coffee. I’m not sure if I felt sillier after doing that, or going into a Starbucks asking for a cup of coffee, as opposed to giving a set of instructions seemingly precise enough for pharmacogenetic prepration.

  3. “she doesn’t regard marijuana as a harmful drug when compared with Xanax, Valium, Prozac, and other pills”
    Hmm…one of these things is not like the others. Anyone looking to get a buzz from Prozac will be sorely disappointed.

  6. In March, Barack Obama came out in favor of a more “practical view” of medical marijuana, saying that “if it’s an issue of doctors prescribing medical marijuana as a treatment for glaucoma or as a cancer treatment, I think that should be appropriate because there really is no difference between that and a doctor prescribing morphine or anything else”
    I can’t find any evidence on pubmed that marijuana has any patient oriented impact on glaucoma. I found one uncontrolled trial from 1980 which showed that marijuana administrations reduced intraocular pressure, but even these authors noted that the side effects preclude routine use. Some poor quality studies (not adequately blinded or very small numbers of subjects)show changes in surrogate measures, like intraocular pressure or “aqueous humor dynamics…kind of like saying estrogen improves cholesterol measures therefore it must prevent cardiovascular events.
    “Cindy” states that she believes cannabis is safer than Prozac, presumably because of the risk of suicide with Prozac. She needs to give me a break. The data on cannabis and it’s association with suicide is far more robust. Here’s one study representative of several:
    http://www.ncbi.nlm.nih.gov/pubmed/17537584?ordinalpos=13&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum
    If cannabis were manufactured by Glaxo-SmithKline or Pfizer, no way would it get this kind of pass from this blog.
    Medical marijuana use as it exists in California is quackery. Few well designed, double blind controlled trials exist for most of the claims made. There is alot of data suggesting harm associated with marijuana use, which these doctors seem to ignore.
    regardless of what you think about drug policy, one would have to admit that cannabis, except for a few narrow indications, would appear to have a terrible risk-benefit profile from a medical standpoint. Anyone can see that. Just do a pubmed search on “cannabis and suicide”, “cannabis and depression”, “cannabis and cancer” “cannabis and psychosis”….then imagine substituting “lipitor” for cannabis and picture the (justifiable)venomous fervor which would result on this blog.

  10. “The Patrick Kelly Project” — AN UNPARALLELED OPPORTUNITY TO
    DECRIMINALIZE CANNABIS IN CALIFORNIA
    If you are a California resident “interested” in marijuana law, for a limited time only you are eligible to comment to the state Supreme Court as it contemplates whether to scrap a recent Appeals Court opinion removing limits on medical marijuana possession.
    Removing those limits forces the state legislature to reform the real problem with marijuana regulation: the prohibition statutes against possession, cultivation, and transportation of cannabis in California: Health and Safety Code sections 11357 and so on.
    What’s at stake is the possibility of total reform of marijuana law in California.
    You are invited to participate in the newly formed PATRICK KELLY CANNABIS FREEDOM PROJECT.
    Be aware that this initiative will probably be opposed by the well heeled “establishment” of marijuana advocacy organizations you may be accustomed to supporting with financial donations. Just ignore them and follow your brain as you read the following paragraphs.
    While lawmakers have spend countless hours over a more than a decade trying to rationalize Prop 215, medical marijuana is a shambles. What’s needed is a fresh start, and the Kelly decision is a brick through a dirty window letting in light and air for the first time since 1996.
    While in 2003, the state legislature established the “safe harbor amounts” in SB 420 to shield patients from arrest, they are readily available for over zealous prosecutors to use as a sword to convict sick people growing or possessing cannabis in excess of those amounts, (six mature, 12 immature plants plus 8 ounces of dried product).
    Defendant and appellant Patrick Kelly was snitched on by a neighbor. He had 12 ounces of dried pot and a few plants to treat his hepatitis, chronic back pain and cirrhosis. He was convicted in Los Angeles courts despite making an affirmative defense under the Compassionate Use Act. The prosecutor reminded the jury over and over the defendant had no special medical recommendation for as much as 12 ounces.
    Kelly’s attorney, Gloria Cohen of Oakland was appointed by the Appeals Court after he accused his trial attorney of incompetence. Cohen pointed out that the legislature cannot modify a voter passed initiative and the court unanimously agreed.
    In one fell swoop, years of wrangling in Sacramento about how to fix Proposition 215 were nullified. And well done. It can’t be fixed, it has to be surpassed.
    AG Appeals to the Supreme Court
    What’s going on now is that attorney general Edmund G. Brown is contemplating another run for the governorship of our fair state in 2010 and needs to show an iron fist when it comes to pot smokers.
    He has appealed the Kelly decision to the California Supreme Court, asking for “depublication” or “review.”
    Depublication is a legal term for erasing the opinion with no explanation. Review is a full consideration with evidence and testimony possibly leading to “reversal.” If the Supreme Court depublishes or reverses Kelly, no one else will be able to raise the same defense.
    While he talks about compassionate this and that, Brown’s legal arguments are cynical. We all know that the “threshold” amounts in SB 420 are actually caps defining what is legal for patients to possess whether or not they are in the voluntary ID card program. His lieutenants’s letter brief ends unapologetically calling for resestablishement of the status quo.
    As a good politician, Jerry Brown has lined up support from both left and right to butt cover his position. Along with law enforcement groups, we find the ACLU and ASA supporting his argument which the Appeals Court in the Kelly decision footnotes call “meritless..”
    Why do these groups which supposedly represent medical marijuana patients and oppose the war on drugs want Kelly to be depublished?
    Could it be they are more interested in seeing their fellow Democrat Jerry Brown replace Republican Arnold Schwarzeneger in the governor’s mansion than in fighting for marijuana liberation? Why don’t you ask them?
    What Brown is saying is that the SB420 limits are constitutional because law enforcement needs them to be. And well they might. If the Kelly decision stands, who knows how many marijuana prisoners will appeal their convictions and go free. Who knows how many legitimate patients will finally be able to use the Prop 215 defense as the proponents intended, no limits attached.
    WHAT YOU CAN DO:
    Only those familiar with the California Rules of Court know you don’t have to be a party to the case or an attorney to comment to the California Supreme Court at this time. Any “interested person” in California may do so. through a simple letter as described below.
    Independently of Kelly and his attorney, Richard Johnson, Green Party marijuana freedom advocate of Mendocino County asks you to carefully but quickly draft and send such a “letter brief” of opposition to depublication of Kelly. He calls this the PATRICK KELLY CANNABIS FREEDOM PROJECT.
    In that letter, you should justify your “interest” in the matter at hand by describing something about California medical marijuana law unique to yourself.
    Here are some examples:
    • I currently advocate a local or statewide reform of marijuana law in California that depends on continued validity of the Kelly decision;
    • I am a defendant in a California criminal case that would be impacted by the Kelly decision;
    • I possess, maintain or cultivate cannabis in California for medical purposes in excess of the SB420 limits, so I am vulnerable to arrest and prosecution under SB420.
    • I am or could be party to a California lawsuit that would be impacted by the Kelly decision.
    Or: “I am a taxpaying California voter and I want the War on Marijuana to end.”
    If the Supreme Court accepts your letter, you’ll see your name in the online docket at
    http://appellatecases.courtinfo.ca.gov/search/case/dockets.cfm?dist=0&doc_id=546238&doc_no=S164830
    The more letters for freedom supporting Mr. Kelly, the less former and would be Govenor Brown’s strategy to reimpose partial prohibition is going to work.
    (To support this project, send a suggested $20 donation to Richard Johnson, Cannabis Freedom Fighter, P.O. Box 533, Talmage, CA 95481.)
    SAMPLE LETTER:
    Below is a sample letter you can use. Sign it with your full legal name. Make it simple, in good English and to the point. Print it on clean white recycled paper with 13 point serif type. Make it no more than than 2000 words or 4 pages and send 14 copies to the address provided, and do it now.
    Send a copy to Green Party Chair Richard Johnson, P.O. Box 533, Talmage, CA 95481.
    For more info, email richard@mendocinocountry.com with KELLY PROJECT as the subject.
    00000000000000000000000000000000000000000000000
    (Date)
    The Honorable Ronald M. George, Chief Justice of California and The Honorable Associate Justices of the Supreme Court of California
    Supreme Court of California
    350 McAllister Street,
    San Francisco, CA 94102-4783
    RE: Supreme Court Case # S164830
    People of the State of California v. Patrick K. Kelly
    Second District Court of Appeal, Div. 3, Case Nos. B195624, B201234 Superior Court of California, County of Los Angeles, Case #VA092724′
    OPPOSITION TO DEPUBLICATION OF SECOND DISTRICT APPEALS COURT RULING IN PEOPLE v. KELLY
    Dear Chief Justice George and Associate Justices;
    On June 30, 2008, the People of the State of California through Michael R Johnsen on behalf of Attorney General Edmund G. Brown requested depublication of the above opinion pursuant to California Rules of Court 8.1125.
    On July 10, RICHARD JOHNSON, Green Party marijuana freedom activist of Mendocino County filed a response to the above People’s Request pursuant to California Rules of Court 8.1125(b)(1).
    Other requests for depublication were filed with permission of the
    court on July 23 by the American Civil Liberties Union Foundation and Americans for Safe Access,
    On July 15, defendant and appellant Patrick K. Kelly through his attorney also filed an opposition.. On July 31, a third opposition to depublication was filed. July 31.
    This court apparently anticipates further requests for depublication from such law enforcement organizations as The California State Sheriff’s Association, the California Police Chief’s Association and the California Peace Officers Association.
    Therefore, the 10-day time limit appears to be suspended. Each new request for depublication may be opposed by an “interested person.” (CRC 8.1125(b)(1).
    THIS WRITER’S interest in opposing the depublication of the Second Appeals Court opinion in Kelly is:
    ————————————————
    FIRST ARGUMENT’
    ——————————————————-
    SECOND ARGUMENT
    ——————————————————–
    THIRD ARGUMENT
    ——————————————————–
    (Total letter less than 2,000 words)
    CONCLUSION
    Therefore, for the above reasons this writer respectfully requests this Court not depublish the Appeals Court’s opinion in People v. Kelly.
    000000000000000000000000000000000000000
    Sign with your real name.

  11. For places where there are armed belligerents who are fighting against stabilization and connectivity, you need enough firepower to keep them under control. For the nation building I envision using people like the Navy SEABEES, the Army Corps of Engineers, and mobile military medical teams that can work with the trigger pullers and do the soft power projection. The major drawback: It costs big bucks.

  12. Medical Marijuana in Focus
    In the July 28th issue of The New Yorker you’ll find an entertaining story by David Samuels that explores the economy of pot in California, where medical marijuana has been legal since 1996. Focusing on the supply and distribution chains that help to get pot in the hands of patients, Samuels weaves a colorful yarn, but one that focuses heavily—and somewhat derisively—on the personalities involved. Given the author’s emphasis on the stereotypical stonerdom surrounding legalization, the casual reader may come away thinking that medical marijuana is just another hippie cause, a 60s-style cultural crusade rather than a question of health care. But that’s not the case.
    ===========================
    pauline

  13. CONCLUSION
    Therefore, for the above reasons this writer respectfully requests this Court not depublish the Appeals Court’s opinion in People v. Kelly.

  15. For places where there are armed belligerents who are fighting against stabilization and connectivity, you need enough firepower to keep them under control. For the nation building I envision using people like the Navy SEABEES, the Army Corps of Engineers, and mobile military medical teams that can work with the trigger pullers and do the soft power projection. The major drawback: It costs big bucks.

  16. Base on what i read,Humans have been consuming cannabis since prehistory, although in the 20th century there was a rise in its use for recreational, religious or spiritual, and medicinal purposes. It is estimated that about four percent of the world’s adult population (162 million) use cannabis annually and 0.6 percent (22.5 million) daily.
    -mj-

  20. Therefore, for the above reasons this writer respectfully requests this Court not depublish the Appeals Court’s opinion in People v. Kelly.

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