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Medicinal Mary

U.S. Supreme Court decision reawakens the debate over the medical benefits of marijuana

The U.S. Supreme Court is on a roll. Months after declaring George W. Bush to be the democratically elected president of the U.S., they have given liberal minds in that country another reason to tremble.

Ignoring the anecdotal evidence of thousand of patients, doctors and researchers – not to mention the overwhelming support of the public – on May 13 the court ruled that marijuana is not to be given to patients whose doctors prescribe cannabis. The court also ruled that the recent laws allowing medicinal use of marijuana in California – and proposed for Maine, Colorado, Nevada, Oregon and Washington – violate the black and white definitions within federal Controlled Substances Act.

One judge withdrew from the proceedings because his brother represented the government in federal court before the case – U.S. vs. Oakland Cannabis Buyers Co-operative – reached the Supreme Court. It’s safe to say that even with his participation the decision would have been unanimous.

Slightly less unanimous was a ruling over whether possession of marijuana for medical use violates the law – five out of eight justices said yes. The other three issued a separate opinion that growing and selling marijuana for medical usage was not a defence.

Barring some convincing medical proof that marijuana is effective medicine in treating various medical conditions, the Supreme Court’s decision is virtually set in stone – medical necessity is not a valid legal defence anywhere in the U.S. for growing, buying, possessing or selling marijuana.

"We need not decide, however, whether necessity can ever be a defense when the federal statute does not expressly provide for it," said Justice Clarence Thomas (yes, the same Clarence Thomas who once bragged of his sexual prowess to Anita Hill). "In this case, to resolve the question presented, we need only recognize that a medical necessity exception for marijuana is at odds with the terms of the Controlled Substances Act."

If the Controlled Substances Act were rewritten with exceptions for medical uses, then medical marijuana might be accepted south of the border. It probably won’t be – not because of the puritan influences that prompt the U.S. to do things like cut aid to countries that support or finance medical abortions, but because the studies that support medical use are a long way from coming.

Multinational pharmaceutical companies finance the lion’s share of medical research in the U.S. and around the world, and are a powerful political lobby in their own right. They look after their own financial interests, and as a result it is unlikely that the medical science or pharmaceutical industries will fund studies to support the medicinal uses of a plant that anyone can grow in the closet.

The U.S. Supreme Court’s decision puts medical marijuana users between a rock and a hard place – continue to use marijuana as part of their treatments and risk going to jail, or switch back to the approved cocktails of drugs that forced them to seek an alternative in the first place.

The same Catch-22 was responsible for the approved use of medical marijuana in Canada when prescribed by a physician.

Toronto’s Terrence Parker had suffered from severe epileptic seizures for his entire life before he discovered that using marijuana helped to lessen the frequency and severity of those seizures. Unable to find or finance what he needed on the streets, he started growing his own plants. He was charged with possession, but successfully argued, all the way to the supreme court of the province, that he needed marijuana to treat his illness.

Since Parker would have to break the law in order obtain the treatment he needed, on July 31, 2000 the court ruled that the Controlled Drugs and Substances Act, which made it illegal to possess marijuana for any purpose other than research, was unconstitutional and of no force or effect.

After the decision was made and the precedent set, the Supreme Court of Canada and the government had exactly one year to redefine the law, or the entire section of the act that made marijuana illegal would become null and void for everybody.

Rather than allow possession of marijuana to become legal, on Sept. 14, Health Canada announced its intention to develop a new regulatory approach for Canadians to access marijuana. The proposed regulations were released on April 6, 2001 as "Marihuana (sic) Medical Access Regulations: Regulations Amending the Narcotic Control Regulations. At the same time the U.S. Supreme Court was reviewing arguments against legalization for medical use, Health Minister Allan Rock and his staff were outlining a plan that will guarantee access in the constitution.

"Due to the health risks associated mainly with the smoked form and the lack of evidence supporting the claimed health benefits, access to marihuana (sic) will be granted under these Regulations in special medical circumstances only: serious medical conditions, including terminal diseases, where conventional treatments may not provide adequate symptomatic relief.

"The necessity to employ marihuana in any specific patient’s case is deemed to be best determined by the medical practitioner as it is for the majority of drugs that are used therapeutically."

Therapeutic uses where marijuana has been shown to be beneficial include:

1. Cancer treatments: Marijuana has proved effective in relieving nausea and vomiting associated with chemotherapy and radiation therapy. For terminal patients, marijuana also offers psychological assistance, and helps patients deal with the effects of pain and painkilling medications;

2. Wasting Syndromes: Marijuana stimulates appetites and weight gain among AIDS and cancer patients;

3. Multiple Sclerosis: Marijuana provides relief for muscle pain and spasms. There are cases of people with MS walking after spending months or even years confined to a wheelchair;

4. Epilepsy: Marijuana helps reduce the frequency of epileptic seizures.

Clinical research facilities have been established, and scientists are working to find ways to isolate the cannaboids within marijuana that give the plant its potency. Within the next few years it’s realistic to expect medical science to be able to provide all the potency and benefits of smoking marijuana in a pill form, thereby eliminating one of the most compelling arguments against the medical legalization of marijuana – namely damage to the lungs caused by smoking.

There is evidence that people can build up a dependence on the drug, but the withdrawal symptoms are generally mild and short-lived – assistance could be provided to help wean medical cases off of the drug.

There is some concern that marijuana can effect pyschomotor skills, reducing your ability to perform tasks requiring concentration and co-ordination, such as driving a car, or remembering the name of that guy who used to play bongos with the Allman Brothers. This is not an obstacle in itself, but medicated people will have to use the same judgement as people who take off-the-shelf allergy and flu medications.

Before a doctor can prescribe marijuana for your condition, they will have to perform a full physical – it increases both your heart rate and blood pressure.

Although a complete study of the effects of marijuana use has yet to be performed, it is suspected that it can have an adverse effect on your immune system – if this can be proved, the range of therapies that medical marijuana is available for may have to be revisited.

The British Columbia Compassion Club Society (BCCCS) of Vancouver has been selling marijuana to people who can provide a doctor’s prescription since 1997, and by 1999 had over 700 customers in the Lower Mainland, ages 18 to 92. Today they serve more than 1,200 customers.

While it is only one of a dozen such clubs in Canada, it is by far the largest and best funded of the non-profit organizations. Once patients pay their annual $15 membership fee, they can purchase marijuana for between $5 and $10 per gram – about half of what it costs on the street. The 30 per cent markup over the growing costs cover the organization’s costs, including a staff of 25 and a facility in East Vancouver.

They support the government’s recognition of the medical benefits of marijuana, but believe the regulations suggested are too restrictive. For one thing, their list of ailments for which marijuana is a suitable treatment is a lot longer: HIV/AIDS, cancer, fibromyalgia, MS, seizure disorders (not limited to epilepsy), chronic fatigue, chronic pain, raised intra-ocular pressure, severe nausea, migraines, hepatitis C, Crohn’s disease, anorexia and other eating disorders, and stress and anxiety disorders.

According to a report by the BCCCS published on May 4, "The draft regulations propose to highly regulate medicinal cannabis, requiring the creation and maintenance of an unnecessary bureaucracy. The bureaucratic authorization process proposed is far more extensive, expensive, and difficult to administer and enforce than regulations for any other drugs or natural medicines. Cannabis simply does not warrant the restrictive and invasive procedures being proposed.

"The proposed regulations are akin to shooting a fly with a cannon; the cannon will do far more damage than the fly ever could. For example a person with Epilepsy would have to try or at least consider undergoing a lobotomy in order to comply with the proposed regulations."

Although the proposed system is not perfect, Health Canada’s proposed regulations might be a good way for medical marijuana supporters to get their foot in the door – if U.S. citizens start to come to Canada for treatment because of the availability of medical marijuana, there’s a possibility that the U.S. State Department will put pressure on the Canadian government to reverse their decision as part of its war on drugs. It’s happened before.

Last summer’s rash of arrests and busted grow operations in the Lower Mainland and around B.C. was attributed by some to pressure put on the Canadian and B.C. governments by the U.S. Attorney General’s Office.

The Canadian government is already under pressure to define the regulations concerning medical marijuana – if Section 56 of the Controlled Substances Act is not rewritten by July 31, two months away, possession of marijuana will become a constitutional right for everyone in Canada.