This article is not another polemic about why it should or shouldn’t be. Today, in any case, the pertinent question is whether it already has been – at least on a local-option basis. We’re referring to a cultural phenomenon that has been evolving for the past 15 years, topped off by a crucial policy reversal that was quietly instituted by President Barack Obama in February.
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In late February, President Obama signaled a new approach. His attorney general, Eric Holder, confirmed at a press conference that he would no longer subject individuals who were complying with state medical marijuana laws to federal drug raids and prosecutions.
This understated act – a simple pledge not to act, really – could have enormous consequences. It potentially leads to exactly the same endpoint as the Twenty-First Amendment, which repealed the federal prohibition on alcoholic beverage sales.
Here’s how. When states make a legal loophole allowing medical use of marijuana, they must grapple with the messy question of what precisely constitutes medical use. After all, doctors regularly prescribe powerful drugs like Valium, Viagra, Prozac, and – give us a break – Botox to patients who are hardly at death’s door.
If a state doesn’t tightly limit what “medical use” means, the camel can get its nose under the tent.
That’s what happened in California. Like most medical marijuana states, California permits doctors to “recommend” marijuana use for patients who suffer from specific serious diseases. (Drafters of the law avoided the word “prescribe” in an attempt to sidestep conflict with federal law.)
California’s law then adds a catchall provision that lets doctors also approve marijuana use for “any other illness for which marijuana provides relief.” In practice, doctors – largely protected from second-guessing by confidentiality privileges – have been free to make the final call as to which conditions those might be.
This is, after all, the norm vis-à-vis medicines. Once a pharmaceutical has been FDA-approved for one use, doctors can lawfully prescribe it for other, so-called off-label purposes, even though the drug has not yet been certified as safe or effective for them.
Accordingly, California doctors are authorizing patients to take marijuana to relieve such ailments as anxiety, headache, premenstrual syndrome, and trouble sleeping. “You could get it for writer’s block,” comments Allen St. Pierre, the executive director of the National Organization for the Reform of Marijuana Laws.
Some California doctors voluntarily report the breakdown of patient medical conditions for which they have approved marijuana use in the Alameda, Calif., medical newsletter O’Shaughnessy’s.
They commonly report that more than a quarter of their marijuana authorizations have been prompted by patients suffering from conditions like “anxiety” or “insomnia.” (The most common complaint is “chronic pain.”)
As a result, in most of California’s coastal metropolitan areas, marijuana is effectively legal today. Any resident older than 18 who gets a note from a doctor can lawfully buy the stuff, and doctors seemingly eager to write such notes, typically in exchange for a $200 consultation fee, advertise in newspapers and on websites.
There are an estimated 300,000 to 400,000 medical marijuana patients in the state now, and the figure is rapidly growing.
More astonishingly, there are about 700 medical marijuana dispensaries now operating in California openly distributing the drug.
