Dying to Get High: Marijuana as Medicine

3.The Greening of Modern Medicine

64 3 The Greening of Modern Medicine Obstructing Science Throughout the late 1990s and the early years of the twenty-first century, the U.S. Supreme Court consistently ruled in support of federal authority over the cultivation and possession of marijuana even for medical use. The justices often appeared sympathetic to the plight of patients, but the majority refused to challenge federal power in this area. The prevailing view appeared to be, as Justice Stephen Breyer suggested, that patients would be better served by working with the federal government rather than against it. Going through the Federal Drug Administration to get marijuana formally approved as a medicine, Breyer argued, would be “the obvious way [for patients] to get what they want. . . . And while the FDA can make mistakes, I guess medicine by regulation is better than medicine by referendum.”1 Breyer’s comments ignore the already more than thirty years of effort by patients and researchers seeking to obtain federal reclassification of marijuana to allow for medical use. As Dr. Rick Doblin, a prominent drug policy critic, has observed, those who have attempted to conduct the necessary research for FDA approval have discovered that the normal approval process has been “politically hobbled” by the “systematic hindrance of scientific research by governmental agencies over the last several decades .”2 These governmental agencies most prominently include the Drug Enforcement Administration and the National Institute on Drug Abuse (NIDA). As the American Civil Liberties Union (ACLU) points out, “NIDA discriminates against scientists who seek to study marijuana’s efficacy and safety. Such research clashes with NIDA’s mission to study only the harmful effects of drugs.”3 It’s not surprising that agencies devoted to the dangers of drug abuse might be uneasy about scientific research focused on the therapeutic value The Greening of Modern Medicine 65 of the nation’s most popular illegal drug. What is surprising, however, is that the DEA and NIDA have been in a position to block even carefully designed, FDA-approved research on the medical value of marijuana. This veto power is the product of a legal monopoly enjoyed by the National Institute on Drug Abuse on the supply of all marijuana to be used in FDAapproved clinical trials. Such an arrangement is unique to marijuana; for every other controlled substance—including other Schedule 1 drugs such as heroin and LSD—researchers can apply to a number of licensed suppliers . But in the case of marijuana, scientists are only allowed to request cannabis cultivated at a single NIDA-licensed facility at the University of Mississippi. The DEA and NIDA have the right, frequently exercised, to refuse researchers access to that marijuana. As Betty Gillespie Pollack, the executive director of the San Francisco Medical Association, observes, “Researchers have attempted to start such studies, only to be blocked by law enforcement agencies that won’t give approval.”4 Yet without apparent irony, in 1997, after more than a decade in which all clinical research into the safety and efficacy of marijuana as a medicine had been blocked by the DEA, federal “Drug Czar” Barry McCaffrey announced , “Drug policy must be based on science, not ideology.”5 On its Web site, the DEA has made similar claims, boldly announcing that, when it comes to “‘Medical’ Marijuana, the DEA recognizes the importance of listening to science.”6 While it is possible that the DEA and NIDA have indeed been listening, science must not have been saying what the agencies wanted to hear. In the 1980s, before NIDA fully sealed off access to marijuana for clinical trials, more than thirty states enacted legislation to make cannabis available to cancer patients through state research programs.7 The federal government immediately began impeding such studies; only six states were successful in securing NIDA marijuana for their research programs. Nonetheless, in each of those state studies, researchers reported that cannabis did indeed have “therapeutic efficacy for patients undergoing cancer chemotherapy.”8 From 1986—when the last of the state studies was completed—until 1998, not a single new patient in the United States received cannabis in an FDA-approved study despite ongoing interest within the medical research community.9 Rather than allowing unfettered research into the medicinal uses of the cannabis plant, the federal government instead diverted scientific research into the development of a pharmaceutical substitute. Seventy-five percent of the funding for research into synthetic THC (one 66 The Greening of Modern...