Legislatures in Vermont and Maryland have moved toward legalizing the medical use of marijuana. In addition, recent legal challenges in two jurisdictions have ruled in favor of the controversial use of marijuana for patients with cancer, HIV/AIDS, and other debilitating illnesses.
In Vermont, the state Senate in March passed a comprehensive measure legalizing and tightly controlling the cultivation and use of marijuana by patients. The Vermont Psychiatric Association (VPA) has actively supported the effort to legalize marijuana for specific purposes under significant controls and restrictions.
"The VPA took this position because we felt that decisions about health care should remain between individuals and their physicians," noted VPA public affairs representative David Fassler, M.D., who is also an APA trustee-at-large. "In general, we are wary about government intrusion into the practice of medicine. We realize that the use of marijuana for medical purposes remains controversial. Yet, many of the treatments we use in medicine today are controversial. We are concerned, however, when these issues get overly politicized. In general, that isn’t a good way to make public policy."
In December 1997, APA published a position statement emphasizing that "while adequate research evidence is lacking at this time to support the medicinal use of marijuana, there is clinical experience claiming potential usefulness of marijuana in patients with AIDS and other debilitating conditions, such as for symptoms of pain and vomiting, promotion of weight gain, and reduction of intraocular pressure."
The position statement notes that research to substantiate these claims should be expedited and concludes that marijuana should be approved for medical uses and controlled as a Schedule II drug under the provisions of the Controlled Substances Act.
Currently, marijuana is a Schedule I substance, defined as having a high potential for abuse and addiction and no accepted medical uses.
However, in 1999 the Institute of Medicine, at the request of the White House Office of National Drug Control Policy, reviewed the scientific evidence on the medical use of marijuana and found that "scientific data indicate the potential therapeutic value of cannabinoid drugs for pain relief, control of nausea and vomiting, and appetite stimulation." It recommended strictly controlled and defined clinical trials of marijuana and the multiple cannabinoid compounds that are found in the plant.
Supporters of legalizing the medical use of marijuana in Vermont agree, arguing that marijuana simply shouldn’t be listed as a Schedule I drug.
A report by the Vermont State Legislative Medical Marijuana Study Committee released last December described 13 findings. The first finding was "there is medical value in using marijuana to ameliorate some symptoms associated with severe illnesses and the treatment thereof." That finding alone, the report noted, contradicts the requirements for placing a drug in Schedule I. Another finding states that "marijuana is misclassified by the federal government as a Schedule I drug and should be reclassified to permit physicians to prescribe and pharmacies to dispense medical marijuana."
Both the Vermont Attorney General’s Office and the state’s attorney endorsed those two findings. The remaining findings describe a potential system for distribution and control of medical marijuana and were generally endorsed, with some amendments, by both offices.
The Vermont bill, S 76, passed the state Senate in March. A similar bill passed the state House last year and is awaiting reintroduction. The new law would require patients who want to use medical marijuana to register with the state and to be certified by a physician as having one of a short list of specified conditions. A panel of three physicians set up by the Vermont Department of Health would decide whether a patient is eligible under the program.
If eligible, a registered patient or his or her registered caregiver would be allowed to grow and possess a limited amount of marijuana. The plants and any marijuana for consumption would have to be secured, and both patients and caregivers would be issued identification cards. Consumption of marijuana would be strictly limited to the patient’s residence.
Howard Dean, a former Vermont governor who is a physician and candidate for the Democratic nomination for president of the United States, strongly opposed the measure, as does his successor, Gov. James Douglas, who cites law-enforcement concerns.
In Maryland, during the same week the Vermont bill passed, state delegates gave preliminary approval to a measure that would essentially decriminalize the use of marijuana for medical purposes by significantly reducing the penalties for possessing or using the drug. A similar bill was awaiting action in a Maryland Senate committee in late March.
Maryland Gov. Robert Ehrlich Jr. (R) has indicated that he could support the bill, which would cap the penalty for possession or use of marijuana at $100, with no possibility of jail time.
In essence, the bill gives judges the ability to consider "medical use of marijuana as a mitigating factor," and proponents of the measure hope that judges would simply throw out charges brought against a patient using marijuana for medical purposes.
Last year, residents of the District of Columbia won a suit in federal district court after Congress attempted to stop a ballot initiative allowing residents to vote on legalizing medical marijuana. The court said that Congress—which has jurisdiction over D.C.—had overstepped its authority, infringing on residents’ right to self-determination. Since that ruling, D.C. residents have not voted on such an initiative
Last fall, a federal appeals court in San Francisco ruled that the federal government may not revoke the licenses of doctors who recommend marijuana to their patients. The ruling upheld a five-year-old district court decision in California responding to the federal government’s threat to revoke the DEA licenses of physicians who recommend marijuana to patients. The appeals court decision indicated that the federal government’s policy interfered with the First Amendment right of free speech, in this case between physicians and their patients.
Alaska, Arizona, Colorado, Hawaii, Maine, Nevada, Oregon, and Washington state also have enacted medical marijuana laws. ▪