Medical Marijuana

A new report by the Transform Drug Policy Foundation outlines how drugs might be regulated in a post-prohibition age.

On the pace of decriminalization, the report warns:

Proceeding on the precautionary principle -- that is, bringing in any new regulatory regimes in an incremental, cautious way -- represents the most constructive and responsible way of developing such regimes. Such an approach both ensures that each regulatory step can be carefully assessed, (and reviewed if unintended negative outcomes emerge), and allows individual countries and/or regions to fine-tune their approach according to local economic, cultural and behavioural norms.

A five-point spectrum is provided for how various substances might be regulated, ranging from perscriptions to unlicensed sales. The authors specifically highlight marijuana as the most likely candidate for decriminalization, in light of recent developments towards decriminalization. 

[H/T: Matt Kelley. Image via danhydankoht.]

Abusable drugs are regulated by federal law pursuant to treaty obligations. Since pharmaceuticals are sold in interstate commerce, their regulation is also a federal matter. But the practice of medicine is regulated by the states.

Cannabis is an abusable drug with therapeutic properties. (Sativex, an extract containing all the active agents in whole cannabis, is now an approved drug in Canada.)

Cannabis can easily be produced locally, with no interstate commerce involved.

Several states have laws designed to make cannabis, despite its status as a Schedule I controlled substance under Federal law, available to patients whose physicians want them to have it for therapeutic purposes. California has gone the farthest down this road, with more many hundreds of "dispensaries" -- in effect, retail outlets -- now in operation, and physicians allowed to "recommend" cannabis for any condition or symptom, even something as unspecific as "anxiety."

The California system has become an open joke, with physicians advertising themselves as "herbal recommendationists" and promising that if a visit doesn't lead to a recommendation there will be no fee. As a result, the "medical" market now makes up a substantial fraction of the total cannabis market in California, with revenues estimated in the hundreds of millions of dollars per year.

The precise shares of the "medical" cannabis market made up by (1) truly sick people with conditions cannabis might help - MS patients with spasm, HIV patients in search of appetite enhancement, chemotherapy patients fighting nausea - (2) chronic users in effect getting maintenance doses for their cannabis dependency, and (3) frankly non-medical users remains unknown, but few believe that the first category accounts for as much as 10 percent of the (massive) volume of the "medical" cannabis industry.

Those efforts have, naturally, led to conflict between state and federal governments. The Supreme Court struck down a DEA effort to strip physicians of the federal licenses they need to prescribe controlled drugs as punishment for recommending that their patients use cannabis. But it later ruled in Gonzales v. Raich that the California statute did not protect either providers or recipients of cannabis from federal prosecution.