
The
Truth About Medical Marijuana
Thursday,
October 2, 2003
Hotel Nikko, San Francisco
Ed Rosenthal
Activist, co-author (with Steve Kubby), Why
Marijuana Should Be Legal
Donald I. Abrams, M.D.
Professor of Clinical Medicine, UCSF Medical Center
Edwin Dobb
Contributing Editor, Harper’s Magazine
Robert J. MacCoun
Professor of Law, Boalt Hall School of Law; Professor of
Public Policy, Goldman School of Public Policy; co-author (with Peter
Reuter), Drug
War Heresies: Learning from Other Vices, Times & Places
Contents
David Theroux Contents
President, the Independent Institute
Good evening, ladies and gentlemen. My name is David
Theroux and I’m the president of The
Independent Institute. I’m delighted to welcome all of you
to our program this evening. As you know, its title is “The
Truth about Medical Marijuana.”
We’re delighted that our program tonight is also co-sponsored by our
friends at Harper’s Magazine, the Drug Policy Alliance, and the
Richard and Rhoda Goldman School of Public Policy at the University of
California in Berkeley.
The Independent Institute regularly sponsors the Independent
Policy Forum, a series of lectures, seminars, and debates held here
in the San Francisco Bay Area. In all of our programs, we seek to get
beyond the stereotypes of left and right and feature speakers that will
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We also invite you to visit us at our website, which is at Independent.org,
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Independent Review. It’s a quarterly journal, and there
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program tonight.
Our next event is going to be held on November 13th. It will be held at
the Independent Institute’s conference center, which is located in
Oakland just off of Route 880 by the Oakland airport. The topic will be
the USA
Patriot Act and the assault on civil liberties. The program is being
organized by our Center
on Peace & Liberty and will feature Margaret Russell, who is
chairman of the ACLU of Northern California and professor of law at
Santa Clara University, David Cole from Georgetown University Law
Center, and best-selling author James Bovard. We hope that all of you
will be able to join with us.
Also in the program handout that hopefully everyone got, you will find
information about the institute itself; and we hope that each of you
will join as an institute associate member and become more directly
involved in the battle over issues such as what we’ll be addressing
this evening.
To set the stage for tonight’s discussion, I want to mention a few
developments that are worth noting. Articles today in Reuters,
the New York Daily News, and USA Today now corroborate a
major new National Enquirer story that Rush Limbaugh [Laughter],
the influential talk show host and highly vocal supporter of the War on
Drugs, is under criminal investigation by the state attorney general of
Florida for his buying and maybe consuming thousands of addictive pain
killers from a black market drug ring over the past four years.
[Laughter and applause.] If true, how again do you spell
“hypocrisy”?
In 1996, California voters passed Proposition 215, allowing physicians
to recommend marijuana for medical purposes. To date, as I understand,
10 states have enacted medical marijuana legislation that is actually
being implemented, and a total of 36 states and the District of Columbia
have formally recognized, in various ways, the value of medical
marijuana. A year ago the 9th US Circuit Court of Appeals ruled that
doctors have a constitutional right to discuss marijuana with their
patients, but in refusing to accept the role of the electorate, the
federal government has been fighting back.
Earlier this year, Oakland resident Ed Rosenthal was the target of the
federal government’s campaign to destroy legal medical marijuana in
California. The case and subsequent verdict against Rosenthal was based
on withholding key information from the jury, including the fact that
Mr. Rosenthal had been deputized by the City of Oakland, under
California law, specifically to attend to the seriously ill. In the
case, Mr. Rosenthal faced a sentence of 60 years in federal prison.
However, facing subsequent public outrage about the case, including a
public protest by the jurors themselves, the presiding judge handed down
a sentence of only one day in jail and a nominal fine. But Ed Rosenthal
remains a convicted felon and is currently seeking to have his sentence
overturned in a state with “three strikes and you’re out.”
Interestingly enough, in the current recall election in California all
of the major candidates from across the political spectrum, including
those that dropped out, have endorsed the legality of medical marijuana.
How times change. Clearly, this is a reflection of the fact that over 70
percent of the public supports medical marijuana. Not to be discouraged,
however, the Department of Justice has since asked the US Supreme Court
to allow it to punish medical doctors who recommend marijuana, and the
DEA continues to raid and close down clinics. Meanwhile, Congressmen
Barney Frank and Sam Farr have each submitted bills to reduce the
federal classification of marijuana, to decriminalize its medicinal use,
and to allow defendants in federal cases to claim compliance with state
laws. Unfortunately, neither bill probably has much chance yet of
passage.
There are many questions to ask about federal policies, state policies,
who benefits, who loses. Is California leading the nation? What kind of
views are actually being presented and based on what? And what about the
lives of people who are suffering from cancer, AIDS, MS, and many other
serious ailments? What happens to them in the meantime? Our Independent
Policy Forum this evening has assembled several of the foremost experts
to discuss the past, present, and future of medical marijuana.
So I would like to introduce our speakers. Please hold your applause
until I complete the introduction. First, to my left, your right, is Ed
Rosenthal, the noted activist and best-selling author who has been a
pioneer, as you all know, of the movement for medical marijuana. In 30
years of study, writing, and activism, he’s become a trusted expert on
medic marijuana use and social policy. He’s also the co-author of an
important book that we are featuring this evening called, Why
Marijuana Should Be Legal, and there are copies on the front
table. He’s written over a dozen other books on the subject.
To his left, again your right, is Rob MacCoun. Rob is professor of law
and public policy of the Goldman School of Public Policy at the
University of California Berkley and co-author of the other book that we
are featuring this evening, Drug
War Heresies from Cambridge University Press. He was formerly a
behavioral scientist at the Institute for Civil Justice and the Drug
Policy Research Center at RAND Corporation. He’s one of the world’s
foremost authorities on drug policy.
To my right is Edwin Dobb. Edwin is contributing editor to Harper’s
Magazine. His writings on civil liberties have been published in Harper’s,
Amnesty Now, and San Francisco Magazine. He was formerly
senior editor of The Sciences. He writes for New York Times Magazine
and is a visiting lecturer at the Graduate School of Journalism also at
UC Berkeley.
Finally, I want to introduce, to his right, your left, again, Donald
Abrams. Don is professor of clinical medicine at the University of
California here in San Francisco and one of the leading researchers in
the world on medical marijuana. He’s also assistant director of the
AIDS program at San Francisco General Hospital, and since 1981, has been
involved in several landmark studies on HIV and AIDS. He’s conducted
clinical trials of marijuana since 1997, including trials with grants
from the National Institutes of Health.
So, please join with me in welcoming the speakers. [Applause.]
Before we begin, a couple of quick program matters I want to mention.
After our discussion, we will have questions from the audience, and in
the program that each of you have there should be a question card.
Please just jot down your question during the presentations and there
will be people circulating the aisles to pick up the cards for the
Q&A period. In addition, after the Q&A period we’ll adjourn,
and Mr. Rosenthal and Mr. MacCoun will be available to autograph copies
of their books in the front lobby where you registered. So without
further ado, I’m very pleased to introduce Ed Rosenthal. [Applause.]
Ed Rosenthal Contents
Activist, Author: Why
Marijuana Should Be Legal
The first thing, I’d like to thank The Independent Institute for
sponsoring this forum and creating it -- I think that this is pretty
incredible -- and especially you, David, and also Bill Selover who is
here. They’ve just done so much work in getting this together. It’s
inspiring. And I’d like to thank everybody who’s here and, in fact,
the entire community, because the reason why I am here and can be
here tonight is because I was only given a one-day sentence, and that is
because of you. It wasn’t because of the judge. It wasn’t because of
any of the legal things. It was because of the pressure that the
community and the media placed on the court system. So I’d like to
give you a hearty thanks for that. [Applause.]
The issue of medical marijuana is of prime importance to perhaps 100,000
Californians who use marijuana in one way or another for their health,
who have been given recommendations by doctors because it may improve
the quality of their life. It may maintain their health or it may
actually keep them alive. And so this is not just a loose issue or
something like that. And this issue not only affects Californians but
also people throughout the nation. There are probably somewhere between
half a million and a million people who use marijuana medically whether
or not they have a recommendation for it.
Now, I’d like to go into a little bit about my case. As you know, I
was convicted on three counts and those are cultivating marijuana,
maintaining a place where marijuana is cultivated, and also conspiracy
to cultivate marijuana. And, as you know, this was the result of a jury
that was kept ignorant of the facts of the case -- that I was deputized
by the City of Oakland, I was providing medical marijuana, that I was
told by the city that I was immune from prosecution. And once the jury
found this out -- when they went home and read the newspapers that they
hadn’t been reading while they were jurors -- within hours they got
back to the media and repudiated their sentence. And, of course, that
did not have a judicial meaning, but it certainly had a meaning to the
media and it certainly had a meaning to the public, because this case
was not fought just on one level. It was fought on two levels. It was
fought in the court -- and so far we’re losing the court case -- but
in the court of public opinion we’re the winners.
And I want to mention something. Most of us, when we vote, we realize
we’re minority voters in one way or another. We vote for all these
candidates that don’t win quite a bit of the time, and we vote for
causes that seem to be lost causes, but we’re the majority. When it
comes to medical marijuana, we are the majority. Anybody who’s opposed
to it, they’re in the minority. It’s a very unusual position to be
in for most of us, I think. [Laughter.]
But we have to realize that we’re not trying to convince people that
medical marijuana is efficacious, or that it works, or that it should be
legal. We’re just trying to convince a few politicians of it who are
being wagged by the tail and I’ll get into that.
Actually, eight of the jurors repudiated the verdict, two of the
alternates. This had never happened before in American history.
Now, I notice that it’s heating up because six members of the jury in
the Oakland case -- I’m talking about the “Riders” case -- have
just complained about what happened in their jury.
So, four days after the jury convicted me, they were back in the
courtroom, in the audience section, for the judge to look at while he
was deciding whether I was going to be remanded into custody
immediately.
Now, I know that most of you were very relieved that I was given only a
one-day sentence six months later, but I was more ambivalent about it.
Because, it’s pretty good getting a one-day sentence, and actually the
government owes me 12 hours because I served 36 hours. But let’s say
they had given me five years and remanded me to prison right then and
there. It would have been a lot more headlines. I would have had a book
sold by now. [Laughter.] And I think it would have moved the laws. And I
think that the government and the judge realized that, if he had done
that, that it would have caused quite a bit more controversy. I’m
going to just use the word controversy.
Right now, the government is appealing my sentence and they’ve wanted
me to do the 21 months, or five years, or whatever, and I’m appealing
the conviction both on technical and on constitutional grounds. And I
wanted to go through them because they’re of importance.
And the first is that the judge, in pre-trial, was looking at the search
warrant, and he realized that the DEA agent, Pickett, had lied on the
search warrant. So instead of allowing a withering cross examination, he
said, “Well, I’m just going to excise certain parts of the search
warrant,” and what was left, after he excised everything, was that I
had a high electric bill. And then my attorney said, “Well, let’s
compare it with other electric bills in the area,” and the judge said,
“I’m not going to allow it, because there are industrial users in
the area, and then the search warrant might not be good.“ So we’re
appealing on that basis.
Then we’re appealing because the judge found that the prosecutor had
actually lied to the grand jury, and the judge found that he had misled
the grand jury. But the judge said that no harm was done. And I don’t
know. If one of you had lied to the grand jury, you would be up for
perjury, and here the prosecutor is lying to the grand jury, and he
shouldn’t have even been testifying.
So those are the two technical grounds that we’re appealing on, and we
may very well win on those grounds. If we win, for instance, on the
first one, it would mean that the way that search warrants are looked at
would change, and the change would have court precedent there. But there
are other, more important, issues that we’re covering, and I’m going
to go through these very quickly.
The first is the 9th Amendment. Now, you know, the 9th Amendment has
never been used in court record, or it’s been used very little. Even
the Griswold decision, which was for birth control, and the
abortion decisions, did not rely on the 9th Amendment. And what the 9th
Amendment says is that those rights of the people that are not
enumerated in the Constitution, remain with the people and shall not be
denigrated.
That means, for instance, you have the right to eat strawberries.
There’s nothing in the Constitution that says that you have an
inherent right to eat strawberries, but you have it because it’s in
there. Those are some of your natural rights.
And there are two natural rights that the 9th Amendment covers in this
case, and the first is that you have the right to seek help. Everybody
has the right to seek help in their own way, whether you want to use
herbal supplements, or whether you want to use vitamins, or whether you
want to use religion and prayer for your health. You have a right to
determine how you will gain your health. And so, by restricting medical
marijuana, the government is restricting your right to health.
The second part is this: Before the Constitution, people in the United
States had the right to use marijuana. Up until 1937 there were no
federal laws against marijuana. So that was practically 150 years during
the United States that people were using marijuana.
Then in 1937, the government realized that, in order to restrict
marijuana, it would have to pass a constitutional amendment. So instead,
it passed a tax law that was confiscatory. It was $100 an ounce tax,
which in 1937 was a lot, since an ounce only cost a couple of dollars.
So people would be arrested not for possessing marijuana but for not
possessing the tax stamp, or paying the taxes on the substance. It
wasn’t until 1968 that marijuana was made illegal. I believe that’s
unconstitutional. People had the right to use marijuana through that
entire period of time, and it was only in 1968 that it was made illegal.
Well, if people had the right to use it, then that was a Constitutional
right. How can that be denied?
Years ago I wrote a paper that said that the 9th Amendment is probably
going to be the amendment of the 21st century -- and I hope this is the
first case on it.
Then the 10th Amendment, that’s the state’s rights amendment -- that
any rights not given to the federal government remain with the states --
and the state has two basic rights in this area. One is to regulate the
health of its citizens, and the other is to regulate doctors. So the
federal government is violating these rights in terms of the 10th
Amendment. And where this comes in, especially in my particular case, is
in the Constitution -- and these are interwoven -- but in the commerce
clause of the Constitution, which regulates interstate commerce. Well,
look, this marijuana was grown in California, by Californians for
Californians. It was recommended by California doctors for people to use
in California. I fail to see where there’s any interstate commerce.
So, if there’s no interstate commerce, and the state has a right to
regulate health, and it’s already determined that marijuana is good
medicine, then why is the federal government in here at all?
And then another issue is 885d, a federal law that’s part of the
Controlled Substances Act. If you’re a federal, state, or city health
and safety officer, and in the course of your business, you’re dealing
with controlled substances, you’re immune from prosecution. Well,
that’s so that narcs can buy and sell pot and other drugs and not get
arrested for it. And I was a health and safety officer that the City of
Oakland had appointed, and I was told by the city attorney’s office
that I was immune from prosecution under this law. And Judge Breyer said
that a literal meaning of this would seem to immunize Rosenthal from
prosecution. But then he said, “I’m not going to allow that,” and
then he didn’t allow the jury to hear it.
And then there’s the other thing. Let’s say the city attorney was
wrong. Let’s say the city attorney’s office was totally wrong, and
they had told me that I was immune from prosecution but I wasn’t.
Well, then, I should have been immune from prosecution because of
estoppel, which means that, if you’re told that something that
you’re doing is okay by the federal government, they can’t then come
in and say, “Look, it isn’t right. You’re breaking the law and
you’re under arrest.” That’s the idea of estoppel. Needless to
say, I was a little surprised when I was arrested, and as you know, I
never felt guilty.
I’ll tell you why I did this. First of all, I’m successful, which is
pretty unusual in America, and I own my own publishing company. And so
I’m an upper-middle class, a middle class person, and I did not have
to get involved in this. This is not my source of income. And the reason
why I got involved in it was because the City of Oakland asked me to
help patients.
There are all kinds of sayings in life, and we read about most of them
as they come out of the Ten Commandments in the daily papers, based on
lust, greed, robbery, lying. [Laughter.] But then there are other sins
too, and sort of sins of omission. When you see somebody who needs help
and you say, “I’m not going to render that person help“ --
that’s a sin. That’s a sin as much as lusting after somebody
else’s wife, or husband, or whatever. So I felt I was living with this
and then, and when the city said, “Well, you have immunity,” well, I
had no excuse not to do it.
And then there were personal things like if I can legally grow
pot. Just the thought of that. You know, the federal government says
that pot’s addictive. Well, I don’t think that marijuana is really
addictive, but growing it is. [Laughter.] And so, when I was
given the opportunity to legally grow marijuana, I jumped at that.
So, given all these circumstances, it was inevitable that when I was
arrested, I would be fighting this. I had just read a book a few months
before I was arrested called The
Tipping Point, which talks about movements, and how movements
form, and how little things make big changes in society. I think I was
really fortunate in reading this book because it gave me insight into
what was going to happen to me, what was happening to me, and what was
going to happen to this issue.
And, after all, the one thing that this did was change the paradigm in
the way that people think about marijuana and the way the press reports
it. And this is exactly what the federal government was afraid of. This
is what they’ve been trying to stop. And their doing this actually
made me into a much better activist than I’d ever been.
One of my ironic thoughts is that for 35 years I was trying to think,
“Well, what would make me a more effective activist? How can I be a
more effective activist? How can I get this into the media so I could be
speaking at places like The Independent Institute instead of at mass
rallies?” So the federal government found it out for me. And so let
this be a warning. You’d better be careful what you wish for.
[Laughter.]
So now the real question is, Why does the federal government want to do
this? What do they have in it? What’s their vested interest in it
this? And I have two ideas about this.
The first is that they really hate marijuana more than any other drug,
whether it’s legal or illegal. And the reason for that, whether
you’re talking about tobacco, alcohol, amphetamines, cocaine, heroin,
all those drugs ultimately make you dysfunctional in one way or another
or can kill you. And the problem with marijuana, as far as the police
are concerned, is that there is no payback to the people. They don’t
get any dysfunction from it. They might be happier than the police are.
[Laughter.] It doesn’t fit the Puritan ethic that if you have
enjoyment, that in some way you have to pay for it. And I think, in a
way, that’s the psychology of the police, but there’s something much
more important. The whole criminal justice industry is based on arrests
and on catching criminals. And so, if you decriminalized or regulated
marijuana, then 8 percent of their budget would be down the drain. Eight
percent of their budget. One out of every 12 arrests. One out of every
12 jails. One out of every 12 cop cars. One out of every 12 judges. It
goes on and on down the line so that we’re talking about a tremendous
amount of money.
And the marijuana war cost the federal government and the state
governments -- that means us, really -- somewhere between $15 billion
and $30 billion dollars a year, and I’ll give you some quick
statistics on that. There are about 730,000 people who were arrested for
marijuana last year, 88 percent of them for simple possession. There are
probably between 100,000 and 150,000 people in prison right now for
marijuana. There are 20,000 people in federal prison for marijuana right
now. It costs the government $1.5 billion dollars just to house a small
town of 20,000 people. Half of those people are Hispanic, so there are
10,000 Hispanic people in federal prison just for marijuana.
And so if you could think of how much resources are spent on this,
it’s incredible. So let’s give a hypothetical. Let’s say tomorrow
everybody stopped using illegal drugs, or let’s say they just stopped
using marijuana. So the police went out to arrest people. There was
nobody to arrest. Nobody was selling marijuana on the street. Nobody was
using it in their home. It wasn’t being used. It would be a disaster
for the DEA. Could you imagine that?
Now, the DEA has had a pretty good growth period over the last 65 years.
In 1937, when the tax stamp came in, there were estimated to be 55,000
users. Now last year there were 730,000 arrests. The arrests totaled 13
times the number of users when marijuana was originally regulated. There
are 25 million users for the Feds and state authorities to poach upon.
They’ve had a tremendous success. If you take a look at these
statistics, statistical impossibility is going to happen sometime around
2020, when there will actually be more marijuana users in the United
States than there are people. [Laughter.] So let’s see.
Now, I wanted to step back for a moment from this and get into what this
is all about. And let’s say we were talking about a river, and how we
were going to use this river. And there’d be all these stakeholders in
this river and the water that this river provided would get together and
talk about it. You might have farmers, and urban people, and urban
communities, and environmentalists, and maybe there would be fishermen
who might get involved in it. And together they’d reach some sort of
compromise that probably nobody would like but that everybody could live
with or sort of live with. So let’s look at the stakeholders, in terms
of medical marijuana. Well, you have patients. You have the doctors. You
have the providers. You have caregivers. You have manufacturers. And all
these people have something to lend to the discussion. You have the
Public Health Service. They might have something to say about it.
Insurers might have something to say about it, because they might have
to pay for it.
But where are the police in this? Where is the criminal justice system
in this? What’s their stake in this? They claim to have a stake. Do
they have a right to poach upon people? To poach upon sick people? Just
what is their stake in it? And this is the problem. Their stake in this
is arrests. They need arrests or else they can’t justify their
budgets, and that’s what this whole thing is all about. And that’s
why this is a culture war. We will hear later that this is a culture
war. And this is part of the culture war. Whether they have a right to
arrest a certain group of people because they’re using this substance
just so that they can arrest them.
Can you imagine all of the wasted resources of this? The thousands and
thousands of people whose lives are being ruined. 730,000 people were
arrested last year. That doesn’t affect just 730,000 people. It
affects millions of people. It affects their families. It affects their
employers. It might affect their employees. It affects them if they’re
college students, because they lose eligibility to all federal grants.
So 730,000 arrests -- and it doesn’t stop at the end of the year.
These 730,000 are processed. It continues all their lives. They might
lose professional licenses. They might lose the ability to continue with
their education.
So, when we step back and we see who are the stakeholders, here’s what
I think. The police, the criminal justice system, is not a stakeholder
in whether medical marijuana patients should be able to use marijuana,
or how much they should be able to use, or how they should be able to
grow it. They have absolutely no expertise in this area. Any expertise
that they claim to have is negated by their official organization, the
California Narcotics Officers Association. You can go onto the Internet
and look at their position papers and here is what they say:
“Marijuana is not a medicine.” These people are verbal terrorists.
Now, the reason why I say they’re verbal terrorists. In order to
remain a police officer in California, you have to continually get
education. You have to take educational classes. And the California
Narcotics Officers Association is deputized to give some of these
classes. So this is what they’re teaching their students, who are the
police. That marijuana isn’t a medicine. That anybody who’s using it
is using it as a ruse. “Don’t believe it. Bust them now and let the
courts sort it out.” And they’re giving a training session, in case
anybody wants to go, on November 8th to the 13th. I’m going to try and
register for one. [Laughter and applause.]
And so they’re saying that the people who are supporting medical
marijuana are just doing it as a means of pushing marijuana onto the
public, so that this is the first step. This is the only thing that I
agree with them about, that medical marijuana is only a first step,
because everybody has a right to use it, whether they’re using it
medically, or recreationally, or however they want to use it.
And I know that people will say, the Narcotics Officers Association will
say, “Well, that’s exactly what we said,” but let’s get real.
Does the federal government differentiate between medical marijuana and
recreational marijuana? There’s no differentiation in the law. And, in
fact, what do they tell the juries? No matter what the state law might
be, the federal government doesn’t recognize medical marijuana. So you
have this Narcotics Officers Association functioning as verbal
terrorists in this war. And then they want to sit down at the table with
stakeholders and say, “Well, we’re stakeholders in it too.” But, I
question, where is there stake in it?
And I’ll give you one example of how this played out very recently.
There was recently the Vasconcellos bill, which “former” Governor
Davis is going to decide whether he’s going to sign or not. Part of
the reason he’s going to be former Governor Davis is that he
was always apathetic, and actually, anti-marijuana, and anti-medical
marijuana. And maybe, if he had a little more empathy for a few sick
people, he wouldn’t be in the terrible position that he’s in.
What the Vasconcellos bill originally said, it adopted the SAM, the
Sonoma guidelines, which were 99 plants in 100 or 200 square feet. Well,
after it was ready to go right into the Senate, what happened was
[Calif. Attorney General Bill] Lockyer got a hold of Vasconcellos and
they changed it to six plants.
Now, what expertise does Lockyer have about what six plants will
produce? What does he know about medicine? Why was he even involved in
it? Don’t you think it’s up to the people of this state to make
policy and then for the attorney general and the district attorneys to
follow that policy, and for the police to follow it, rather than for the
tail to wag the dog? That’s where it’s at.
We have a police department that is out of control, and I have to get
off, but there’s one last part of this which is this: If you look at
the Oakland Narcotics Bureau, where do you think they’re housed?
They’re not in the Oakland police building. They’re not at city
hall. They’re not in any of their own buildings. No. They have a space
in a federal building. And narcotics divisions all over the
country are becoming part of the national police. They’re being
directed more by the federal government than by their local police
chiefs, and they are now becoming part of the anti-terror network. And
that’s what we’re dealing with.
We have a big job ahead of us, but we will win this. Here’s something
for us all to say and think about. These laws are doomed. Thank you.
[Applause.]
David Theroux
What I might just add as a footnote to what Ed’s been saying is
there’s a school of economics that is in part at the Independent
Institute called the School of Public Choice. And Public Choice
economists are very well aware of what Ed is talking about as far as the
incentives that police agencies have in fostering and actually
criminalizing behavior for their own benefit.
I want to thank Ed for a wonderful presentation. Our next speaker is
Donald Abrams. [Applause.]
Donald I. Abrams, M.D. Contents
Professor of Clinical Medicine, UCSF Medical Center
Thank you. It’s a pleasure to be here. I wanted to start by telling
you a little bit about how I got into this field of doing research on
marijuana. It’s been a path that’s been ongoing for the past 11
years. It started in 1992. I am an AIDS doctor, as was mentioned. I’m
also a newly appointed chief of hematology-oncology at San Francisco
General Hospital, so I take care of patients with cancer and patients
with AIDS, and that’s what I’ve been doing during my career.
In 1992, the AIDS conference was being held, in all places, in
Amsterdam, and I was in my hotel room, glancing at CNN, when I noticed
that Mary Raften was being arrested. Mary was a volunteer in our clinic
at San Francisco General Hospital. She was about 70. She was known as
Brownie Mary. She won the Volunteer of the Year award two years running
because she came and took our patients to X-ray, and took their blood to
the lab, and picked up their prescriptions, and she also baked brownies
for her kids. And here I was in Amsterdam watching Brownie Mary being
arrested in Sonoma for baking her brownies. When I got back home, there
was a letter addressed to the director of research at the AIDS program
at San Francisco General Hospital. Somebody brought it to me thinking I
was a good enough person to respond to it. And it was from Rick Doblin
who was the president of the Multidisciplinary Association of
Psychedelic Studies or MAPS. Rick is a Ph.D. graduate of Harvard’s
Kennedy School of Government, and his particular interest is in drug
policy reform. Rick suggested that a clinical trial demonstrating the
medicinal benefit of marijuana should come from Brownie Mary’s
institution, as if she were our dean or something. [Laughter.]
Well, 1992 was a bad year for people living with HIV because we really
had no drugs. We only had three, and I had just finished a trial
comparing the three of them, so as a clinical trialist, this was sort of
a gauntlet that I decided should be picked up. So I began to develop a
clinical trial to look at smoked marijuana in patients with the
so-called AIDS wasting syndrome, a very common condition at the time,
where patients lost weight, became very skeletal, had diarrhea, no
appetite. And marijuana is something that these patients were using, to
a large extent obtaining it from Dennis Peron’s Cannabis Club in
downtown San Francisco before it was closed.
We designed a clinical trial, Rick Doblin and myself, and sent it off.
It was really readily approved by the Food and Drug Administration,
surprisingly. The University of California Institutional Review Board
had four pages of issues that I addressed. Ultimately, the question
became obtaining marijuana for the study, and we needed to go to the
National Institute on Drug Abuse where Allan Leshner was the director at
that time.
Allan and I have a correspondence that’s on the World Wide Web. It
gives me a number of Goggle hits, but, basically, he sent me back a
letter after nine months, having reviewed my proposal, and said that he
was sorry that he could not provide us with the marijuana for this
clinical trial because the study was not scientific. Here it had been
approved by the FDA, by the University of California, and controlled
substance studies in California also need to be approved by the
California Research Advisory Panel or CRAP. [Laughter.] I’ve told this
story so much that CRAP has changed their name to the Research Advisory
Panel of California so I can’t make that little joke.
Anyway, it was a little bit upsetting to me that Allan Leschner had
called our study unscientific when all these other bodies had approved
it. It turned out later on that Allan and I became somewhat friendly and
he explained to me something I didn’t realize. The National Institute
on Drug Abuse has a mandate from Congress to study substances of abuse
as substances of abuse and not to provide them to researchers who want
to study these substances for potential medical benefit. As he said,
“Donald, we’re the National Institute on Drug Abuse, not for
drug abuse.”
Anyway, ultimately, in 1996 HIV changed because protease inhibitor drugs
became available that could really suppress the virus. The wasting
syndrome disappeared. This was the year that we in California voted for
Proposition 215, and if you recall at the end of the year, Barry
McCaffrey, flanked by Donna Shalala and Janet Reno, got up there on
December 30, 1996, and said, “No, no, no. Physicians in California and
Arizona cannot talk to their patients about use of marijuana because we
will do all these terrible things to them,” and that’s when
physicians finally began to mobilize. The National Institutes of Health
got together. The Institute of Medicine began to investigate this, and
everybody said we need more research.
Having already written two proposals, we were ready to write a third.
And the availability of protease inhibitors gave us a new twist because
these drugs are metabolized in the liver by the same system that
metabolizes cannabis. So we proposed a clinical trial, not to see if
marijuana was effective in patients with the AIDS wasting, because AIDS
wasting disappeared, but to see if it was safe for people on protease
inhibitors to smoke marijuana fearing that there may be some sort of a
drug-drug interaction between cannabis and their drugs or cannabis and
their immune system, because there was all this concern about what
effect marijuana has on the immune system.
This was successful, and in 1997, we were awarded one million dollars
and 1,400 of the government’s finest 3.95 percent THC-containing
marijuana cigarettes. We conducted a clinical trial from 1998 to 2000 in
which we enrolled 67 patients and housed them in our in-patient general
clinical research center at San Francisco General Hospital for 25 days.
One third of the patients took Marinol, which is synthetic delta9-THC.
One third took Marinol placebo, and one third smoked a NIDA cigarette
three times a day for 21 days. Again, the endpoint of the study was what
happens to the level of the AIDS virus in the blood stream with, also, a
look at the immune system, the level of the protease inhibitors, and
since we have the patient there, we were also going to see what happened
to their caloric intake, their weight, and their body composition.
We completed the study. The study was published, I’m happy to say,
August 18th of 2003, after having been rejected by four major august
journals. It was published in the Annals of Internal Medicine --
which had previously rejected it, but I appealed it because I said they
have published the results of my study in a thought piece on medical
marijuana the year before, and I said, “Here I’m sending you the
original research. I think you should publish it.” And, after a year
of going back and forth about the statistics, they ultimately published
the study.
I will say that the first august journal that rejected it, named after a
region of our country in the northeast -- one of the peer reviewers in a
one paragraph rejection said that these authors sound more like
activists than scientists. I was a bit shocked and I’ve been rejected
by that journal on a number of times, and I said, “You know, this is a
bit biased. And I would be, if I were you, ashamed to have sent this to
an investigator, a letter that’s so politically biased, and rejecting
this paper on the basis of that.”
When a paper goes out for peer review, peers review it and send back
their comments, and the reviewer’s comments in all the journals that
rejected the paper were quite favorable. I think it was the editors of
these journals that were concerned about publishing a study that showed
our results. Our results being that there was no impact on the HIV viral
load, that there was no significant drug-drug interaction between
cannabis and the protease inhibitors, that the patient smoking marijuana
gained weight, three kilograms, compared to one kilogram in the placebo
group, and that, in fact, the immune system seemed to get a little
better in the people smoking, compared to the people on placebo.
So anyway, the study’s done. It’s history. And fortunately for all
of us, we live in the State of California, although who knows what’s
going to happen next week. Although we’ve heard Governor Davis sort of
lambasted, he did approve or not veto John Vasconcellos’s subsequent
bill, which provided money to establish the Center for Medicinal
Cannabis Research at the University of California. I have now been
awarded three grants to study three different conditions in clinical
trials.
Currently, we are doing a study in patients with HIV in painful
peripheral neuropathy, which is nerve damage, leading to very severe
pain in the hands and feet. The patients with peripheral neuropathy do
not benefit from opioids, but they do seem to benefit from cannabinoids
or cannabis, so we have just completed a pilot study, and now we’re
doing a randomized placebo controlled trial of smoked marijuana versus
smoked placebo.
We also have a study for cancer patients who are taking opioid narcotics
and still have pain. This study is looking at the interaction of
cannabis and the opioid analgesics to see if together they provide an
additive pain relief, which we believe they will. We’re also currently
doing a study of women with breast cancer who have delayed nausea and
vomiting secondary to their chemotherapy to see if cannabis or Marinol
provides relief. And the final study that I just hung up from the FDA
with this afternoon discussing is a study to look at the Volcano
vaporizer as a smokeless delivery system.
I believe, personally, that marijuana has medicinal benefit. This is not
news. People have known this for 5,000 years. In fact, it is only over
the last 70 years that physicians in this country could not prescribe
cannabis. What I find myself in the midst of now is a somewhat
Sisyphean, if that’s the right word, effort to reprove that marijuana
is medicine. And we live in an era of evidence-based medicine, so my
goal is to produce evidence that will, hopefully, convince people that
need to be convinced that this is a drug that benefits people who need
it. Whether or not this is a possibility in our lifetimes remains
unclear, but it is the goal of the work that I’m doing. With that,
I’ll stop and thank you very much. [Applause.]
David Theroux
Thank you very much, Donald. Our next speaker is Edwin Dobb. [Applause.]
Edwin Dobb Contents
Contributing Editor, Harper’s Magazine
I speak not as a medical expert or criminologist but instead as a person
whose occupation -- journalism -- forces him to pay attention to certain
perennial questions regarding democratic citizenship. One question
concerns how societal problems are identified and defined. Another
concerns the people controlling the process of definition, in other
words, who determines the way problems are defined, the terms that
dominate public debate, the often hidden–or deliberately
obscured–assumptions that steer and constrain solutions.
The two questions are, of course, intertwined. And taken together, they
constitute an inquiry into the exercise of power. Just such an inquiry
is needed, I believe, to expose what may be missing or under-appreciated
in our approach to the use of such illegal mind-altering substances as
marijuana.
Judging from the language, stories, and images that dominate mainstream
media, the troubles that accompany drug use can be understood in two
ways. On the one hand is the medical perspective, with its emphasis on
illness, treatment, and physicians. On the other is the punitive
perspective, which stresses moral weakness, punishment, the police. Note
that both models are based on roughly the same assumption -- that the
problem springs from some form of individual inadequacy.
Certainly those who actually provide the treatment or mete out the
punishment may and often do hold a more complex and forgiving view of
the people in their charge, especially of the reasons why human beings
make a habit of ingesting mind-altering substances. But I’m speaking
here of the debate as it plays out in the public domain, the fundamental
ideas that define how we as a society frame the issue before us.
Essentially that’s a bipolar world inhabited by sick people and bad
people.
It’s also a relatively new world, brought into existence in 1914 with
the passage of the Harrison Narcotic Act, which for the first time in
this country allowed for the taxation of some mind-altering substances,
leading to the criminalization of their use. During the past 90 years,
the pendulum has swung between punishment and treatment, with punishment
clearly being the preferred alternative, the one to which we’ve
devoted by far the most time and resources. Indeed, among the early
consequences of the Harrison Act was the arrest of physicians who
refused to stop prescribing drugs how and when they saw fit.
As if there weren’t enough about this wrong-headed, profoundly
destructive social experiment to induce despair, consider that we are
once again harassing, arresting, and incarcerating
physicians–physicians who, employing not only marijuana but powerful
opiates, would dare to relieve patients of excruciating, often
end-of-life pain.
Perhaps nothing so clearly exemplifies the worldview of those
prosecuting the War on Drugs than the demonization of doctors. As in the
War on Terrorism, the rhetoric has become wildly inflated and
misleading, allowing for the exploitation of fear and ignorance and the
cynical promotion of self-serving rationales for curtailing the private
behavior of our neighbors. In such a politically as well as emotionally
charged climate, we must choose our words carefully.
For at least a generation, and under both Democratic and Republican
administrations, the threat to society posed by the use of illegal
substances has been deemed so grave that the only reasonable solution is
one that’s described in military terms. The policeman is now a
warrior, and the warrior can’t do his job if his hands are tied.
Ridding the world of evil is a dirty business. Blood will be spilled.
Collateral damage can’t be avoided.
And it’s not enough -- really, it’s never been enough -- to counter
this view with one that simply replaces warriors with healers. By
allowing ourselves to be seduced by the traditional bipolar scheme, and
with few exceptions the mainstream media still encourages this outlook,
we inadvertently ignore a more fundamental issue–rights and
responsibilities in a democratic society. By insisting that the only
alternative to the rhetoric of punishment is the rhetoric of treatment,
we make it easier for those who believe that the War on Drugs justifies
placing new restrictions on the freedom of individuals.
But if instead we move the discussion into a civil liberties context,
the ever-growing dangers of the war itself come into focus and the
strategy of the warriors is exposed for what it is in effect, if not
intention–an assault on the principles upon which the Constitution is
based. At the most fundamental level, the issue isn’t one of sickness
vs. health or bad vs. good. It’s what lengths do we believe the state
can and should go to monitor and control the voluntary, private use of
any substance, regardless of its effects upon the individual. Seen in
this light, the societal problem that truly demands our attention
isn’t drug abuse. It’s the abuse of power.
Preventing the government from overstepping its bounds is probably the
quintessential and enduring topic of debate in robust democratic
societies. So it’s no surprise that the terms were set long ago, and
in this regard, never so forcefully as in John Stuart Mill’s essay “On
Liberty,” written in 1857. Since this goes to the heart of the
matter, it deserves being quoted at length. Here’s what Mill wrote:
“The only purpose for which power can be rightfully exercised over any
member of a civilized community, against his will, is to prevent harm to
others. His own good, either physical or moral, is not a sufficient
warrant. He cannot rightfully be compelled to do so or forbear because
it will be better for him to do so, because it will make him happier,
because, in the opinion of others, to do so would be wise or even
right.” The implications couldn’t be clearer. The state, in this
view, shouldn’t use its police powers to punish adults for what they
ingest. Period. Nor, and this needs to be emphasized, should the state
compel treatment. Period. “Over himself,” Mill says, “over his own
body and mind, the individual is sovereign.” And with such
sovereignty, we must remind ourselves, comes responsibility–should one
person’s exercise of rights lead to excess and bring harm to another.
To favor the expansion rather than the further restriction of freedom is
not to promote a cruel free-for-all in which no one is held accountable
for his actions.
Once the principle of individual sovereignty is violated, all civil
liberties are at risk. Which is the same as saying that all citizens are
at risk. Which is another way of saying that as remote as the use and
sale of illegal substances may seem to some, the War on Drugs, like the
War on Terrorism, is our war, like it or not. It’s being fought in our
name, after all, and with our tax dollars. More to the point, a
government that has no qualms about abridging the civil liberties of
your pot-smoking or cocaine-snorting neighbor could just as easily show
up on your doorstep with an equally unwarranted and intrusive plan to
prevent you from harming yourself.
Merely a partial list of the drug warriors’ current assaults on
liberty explains why former Supreme Court Justice Thurgood Marshall
referred to them as the “drug exception” to the Constitution. Here
are nine reasons why U.S. citizens should take exception to the drug
exception:
1. Restricting free speech. This past August, Attorney General
Ashcroft asked the Supreme Court to overturn the decision of the 9th
Circuit Court of Appeals upholding the right of California doctors to
recommend medical marijuana to their patients. Note the hypocrisy of
those in power who profess a distaste for governmental intrusion yet are
intolerant of states’ decisions in this regard.
2. Invasion of privacy. Drug testing is now routine, with severe
consequences, even though it’s an unwarranted invasion of privacy, no
necessary connection exists between urinalysis tests and impairment, and
the tests can be inaccurate. Imagine getting fired for having had a
drink the previous Friday night. In effect, the state is monitoring and
punishing private behavior that’s unrelated to job performance.
3. Violation of due process. Civil asset forfeiture–the seizure
of cars, homes, and other property–has become one of the nasty little
secrets of law enforcement agencies, because they’ve grown dependent
upon the proceeds generated . More alarming, though, is that, despite
recent reforms, property still can be seized before a person is
convicted of a crime, the property needn’t be involved in the
facilitation of a criminal enterprise, and the burden of proof is less
than that required in a criminal proceeding. Often the most serious
offenders, those with a great deal of money, can bargain for leniency,
further corrupting the process.
4. Cruel and unusual punishment. Beginning with the Sentencing
Reform Act of 1984, mandatory sentencing laws have greatly reduced the
discretionary power of judges, leading to grossly disproportionate forms
of punishment. Other disparities include those introduced under the
Anti-Drug Abuse Act of the late 1980s. Example: Possession of 500 grams
of powder cocaine results in a five-yard prison term, while it takes
only five grams of crack cocaine to get the same punishment. This
obviously discriminates against poor and minorities.
5. Denying access to education. 1998 law prohibits giving federal
aid to students who’ve been convicted of drug crimes. Incredibly,
convicted murderers and rapists are eligible for financial aid, while
those convicted of marijuana or other drug charges are barred from a
year to life. In the last three years alone, about 90,000 people have
been denied aid. This law also discriminates against the poor, those
most in need of education.
6. Homelessness. In 1996, the Department of Housing and Urban
Development enacted a “One Strike and You’re Out” policy whereby a
single drug crime, on or off housing premises, can result in the
eviction of an entire household. Not only does this provision deny
people the right to due process, which prevents one person from being
punished solely because of the actions of another, the law targets
low-income families, those for whom the prospect of homelessness is most
devastating.
7. Disenfranchisement. In 13 states, ex-felons are barred from
voting for life. And in the War on Drugs, thousands of people are being
convicted of felonies every year.
8. Destruction of the social safety net. The Welfare Reform Act
of 1996 denies for life cash assistance, food stamps, and other benefits
to any person convicted of a state or federal drug offense. Although 31
states have eliminated or modified the provision, 19 states still impose
it in full. Once again, even murderers and rapists escape such punitive
measures. And once again, the law singles out the poor, as well as
children, for undue punishment. According to a 2002 report by the
Sentencing Project, more than 92,000 woman and 135,000 children are
affected by the welfare ban.
9. Misuse of informants. Frequently, the only evidence against a
defendant is the accusation of an informant. Under current rules, such
informants can remain anonymous. And given the pressure on everyone
involved to reach a plea bargain, defendants often never get the
opportunity to confront their accuser anyway. A further abuse is the
over-reliance on the testimony of a single biased witness, the recent
case in Tulia, Texas being an egregious example. Twelve percent of the
black population of a town of about 5,000 people were arrested solely on
the word of a corrupt undercover agent. But that was preceded in 2000 by
the arrest of 15% of the black males in the town of Hearne, Texas–this
time on the word of an informant who’d agreed to implicate certain
individuals. All of the men were innocent.
“Nightfall,” as former Supreme Court Justice William O. Douglas,
once said, “does not come all at once, neither does oppression. In
both instances, there is a twilight when everything remains seemingly
unchanged. And it is in such twilight that we all must be most aware of
change in the air -- however slight -- lest we become unwitting victims
of the darkness.”
Changes in the air brought about by the War on Drugs are now so numerous
and troublesome that they cannot be ignored without risking deep and
possibly permanent damage to our form of government and way of life. It
is dusk in America and vigilance is required to navigate in the fading
light. This is the responsibility not of experts in law or medicine or
sociology, though their skill and wise counsel are surely needed, but
instead all citizens. It surely shouldn’t be left to the drug warriors
who, even as we sit here tonight, are laying plans to conflate the War
on Drugs and the War on Terrorism, concocting the so-called VICTORY Act,
a successor to the PATRIOT Act that would greatly expand the
government’s power to seize records and conduct wiretaps, make it
easier to seize property, and so on.
The drug problem, redefined as an abuse of power problem, dictates a
very different set of possible solutions than those that usually
dominate such discussions. And they all stem from an awareness of and
willingness to fight to maintain the real locus of power in a
democracy–the people. The warriors can pursue their ill-conceived
campaign only so long as we permit them to do so, only so long as we
defer to their mad vision, only so long as we view ourselves as
spectators -- or “unwitting victims,” in the words of Douglas.
Civil liberties cannot exist in the absence of citizens who, on the one
hand, exercise them, and on the other, defend them. In the defense of
liberty, we should work toward the day when no one is arrested, charged,
goes to jail, or in any way suffers coercion at the hands of the state
for possessing or using drugs of any kind. Besides protecting the
sanctity of individual rights, this approach would greatly reduce
corruption of law enforcement agencies and help restore the integrity of
the overall judicial system. [Applause.]
David Theroux
Thank you, Ed. For those of you have not followed it that closely, of
course, the USA PATRIOT Act has a successor which was termed PATRIOT II.
Of course, the PATRIOT Act was cynically named PATRIOT Act to appeal to
the public, and when the PATRIOT Act began to get bad PR, of course,
they renamed the PATRIOT Act II to the so-called VICTORY Act, so
that’s the next thing on the horizon. Our next speaker is Robert
MacCoun. [Applause.]
Robert J. MacCoun Contents
Professor of Law, Boalt Hall, Professor of Public Policy, Goldman
School of Public Policy, University of California, Berkeley
Thanks. I’m really delighted to be here. I think the civil liberties
issues are quite important but I’m going to change direction a little
bit and focus more on some empirical questions about the effects of drug
laws on drug use.
I’m actually going to say very little about medical marijuana, because
I actually don’t think medical marijuana is really what’s at issue
here. I think the risk of medical marijuana systems leaking marijuana
into the recreational community is such a trivial problem that I find it
extremely difficult to rationalize the federal government’s interest
in this, taken at face value.
But I think, clearly, what the federal government’s really interested
in here is symbolic politics, the symbolic politics of medical
marijuana, and the perception that medical marijuana is really a Trojan
horse for marijuana legalization, and I think they’re surely right. I
think it’s clear that the medical marijuana issue carries tremendous
political importance.
I’ve been tracking Gallop polls measuring opposition to marijuana
legalization, and if you look back over 30 years, the opposition has
been very stable among adults, 75 percent or 80 percent of the
population. Only recently have we seen that opposition really start
dropping, and I think the opposition is really starting to drop in part
because the federal government has shown pretty much the same kind of
political acumen that the Fox News lawyers showed when they went after
Al Franken. [Laughter.] The problem with going after medical marijuana
is that it brings into focus public views about what we’re actually
achieving with marijuana prohibition.
Jimmy Carter, when he was president, amazingly, said the penalties
against a drug should not be more dangerous to an individual than the
use of the drug itself, and when they are, they should be changed.
Nowhere is this clearer than the laws against possession of marijuana.
I want to open up the context a little bit by looking at, well, what do
we -- what would actually happen if we decriminalized marijuana,
de-penalized marijuana, legalized marijuana. And I come at this not as
an activist telling you what to believe, but as a policy analyst,
definitely not funded by the federal government, but funded by the
Albert Sloan Foundation, the Robert Wood Johnson Foundation, to look at
this question empirically. And I’ve looked at this from various
different angles, looking at historical evidence, cross-national
comparisons, looking at experiences with alcohol and tobacco regulation,
and so on.
I want to tell you about some of the things we know, although we don’t
know everything we’d like to know. The federal government has been
complaining about Canada’s recent decision to decriminalize marijuana
and saying that they’re bad neighbors, that they’re poisoning our
neighborhood. But the Canadians were good enough neighbors in the 1970s
not to accuse us of being “bad” neighbors when 11 of our states
decriminalized marijuana. In fact, we did it first. Eleven states in the
United States decriminalized marijuana meaning, specifically, possession
was downgraded from a felony to a misdemeanor. And it varies from state
to state how this is implemented, whether there’s a quantity limit, or
a frequency limit, or so on.
And so that’s one of the choices of evidence we can look at. When we
look at that evidence, we are unable to find any effect of that legal
change on levels of marijuana consumption. You can’t really detect
any. There’s one study that has shown a very small effect. Nobody else
seems to get the effect. Even the study that finds an effect is very
tiny.
Australia. Some of the regions of Australia have de-penalized it. I
prefer the term de-penalization because I think it’s clearer -- they
have de-penalized possession of marijuana. Both cross sectional and
longitudinal studies failed to find any effect of this on levels of
marijuana use.
The US is increasingly isolated in marijuana policy as country after
country relaxes its marijuana laws. The US federal government has really
been bullying other countries into trying to tow the US party line for a
long time, and a lot of countries are finally saying, “No. We’re
going to go our own way.” Canada has said that. Great Britain has said
that. Many regions of Germany have said that. Australia, Portugal, Italy
and Spain. It’s actually not well known, but Italy and Spain
decriminalized marijuana back in the 1970s. And we don’t find effects
of removing penalties for possession on use. And this is a big part of
what this debate is about, and this looming specter of de-penalization
just does not look like it has any serious consequences.
I do want to talk about distinguishing de-penalization from legalization
and talk a little bit about legalization. Legalization would involve
allowing legal sales of marijuana, and here we really only have one
contemporary example, and even that’s not a perfect example. The
Netherlands. By the letter of the law, cannabis sales are prohibited in
the Netherlands. Don mentioned Amsterdam, but people laughed. A lot of
my research has been in Amsterdam. It’s a tough job, but somebody’s
got to do it. [Laughter.] And what the Dutch actually did was have a
written policy of non-enforcement of sales up to five grams of
marijuana.
The evidence on the effect of commercial sales are very ambiguous, and
it’s very hard to know for sure what’s happening. I will say, during
the 1980s, when there was a dramatic increase in the number of coffee
shops and the visibility of coffee shops, and during the period of the
‘80s, when there was a lot of advertising by these coffee shops, the
Netherlands was the only country that had rising levels of marijuana use
in Europe. The United States had falling levels during that time. I
think it’s not implausible that commercial promotion did lead to some
increase in use. Having said that, it’s very hard to find any
indication that that’s in any way harmed Dutch society, and in fact,
levels of marijuana use in the Netherlands are now significantly lower
than in the United States.
Interestingly, the reason why the Dutch allowed coffee shops to sell
marijuana is that a Dutch sociologist in the 1970s argued that there was
a gateway effect, that marijuana led to hard drug use. And the Dutch
concluded that they needed to soften their marijuana laws. How did they
reach this conclusion? Because they believed that the causal mechanism
of the gateway is that young people come into contact with hard drug
users and hard drug dealers, and so they wanted to separate the markets.
It seems to me, and in my book I reviewed some evidence, that the Dutch
have successfully done this and that they’ve actually weakened the
gateway. It seems to me that probably a less risky way to reform
marijuana laws, if you interpret increased use as a risk, and not
everyone does, would be to follow the model used in Alaska and in South
Australia, which is to allow legal cultivation of a small number of
plants for personal use. There’s no commercial promotion involved.
There’s no advertising involved. And it separates the marijuana market
from the hard drug market without the risk of commercial interest. And
in our book we take a very jaundiced look at the tobacco industry,
gambling industry, alcohol industry, and there are a lot of problems
with monied interests getting involved in an intoxicating substance.
So, one of the threats faced by the slippery slope of medical marijuana?
I don’t think the threats are really all that serious, and it’s
worth looking at them directly. And I think what’s happening is,
increasingly, many countries are looking at the evidence and concluding
that it’s just very hard to justify an aggressive, American-style war
on marijuana. Thanks. [Applause.]
Questions and Answers Contents
David Theroux
And thank you, Rob, very much. We now have plenty of time for questions.
The cards are, of course, designated to different speakers or the entire
panel. The first question is for Ed. What advice do you have for people
just starting out in the medical-marijuana dispensing business?
[Laughter.]
Ed Rosenthal
Actually, there are more dispensaries now than when I was arrested, and
there are more dispensaries throughout California than when I was
arrested, and more and more of these dispensaries are working in
cooperation with local governments. And my advice would be, if you’re
going to start a dispensary, try and make arrangements with the local
government, and try to become an officer of the city, although that
hasn’t helped me much. Dot your I’s, cross your T’s, in terms of
business licenses, and try to work with the parts of the city government
other than the criminal justice system. They’re not going to give you
a hand, but city council members, if there’s a public health service
in the city or the county, organizations like that within the government
will help you. And the other advice that I’d give is, remember that
you’re there to serve your citizens and your clients. It’s not there
for you; you’re there for them.
David Theroux
The next question is for Donald Abrams. In the clinical study of
cannabis, how were the subject’s immune systems improved? Was this
finding statistically significant? Are any researchers looking into this
further?
Donald I. Abrams, M.D.
Yes, good question. The CD4 lymphocytes are the cell that the AIDS virus
infects. It’s the “helper cell” of our immune system, and as HIV
progresses, the number of these cells decline. The CD8 lymphocytes are
the suppressor cytotoxic cells which fight virally infected cells. A
high number is associated with people who are the so-called long term,
non-progressors.
What we saw in the group that smoked marijuana was a very highly
statistically significant increase in CD8 cells compared to the placebo
group. We also saw a CD4 increase that was significant but not as highly
statistically significant as the CD8 increase, so we saw immune system
benefits on both of those parameters. But in a number of other more
extensive immune system studies that we did, we saw no real difference
between the three groups.
David Theroux
The next question is for Ed Dobb. Mainstream news media typically strive
for balance and feel they’ve done their job if they give equal weight
to both sides. Do you see any way to get the mainstream press to do more
probing and more real reporting?
Edwin Dobb
Certainly through this sort of activity. I’m a full-time working
journalist, independent, and I think by my participation in forums like
this, I can have an effect on other writers. I can have some impact on
the way issues are framed. I think simply a matter, in terms of writers
and editors, campaigning for the type of story and the type of approach
to this story that more clearly defines the stakes.
David Theroux
Okay, a question for Rob MacCoun. How can we overturn marijuana laws in
the U.S. while being a signatory to international drug treaties?
Robert J. MacCoun
That’s a very good question. Actually, these international treaties
are one reason why the Dutch have not legalized marijuana. They’ve
come up with this elaborate way of de facto legalizing it because
they’re signatories to these international conventions.
Now, conventions can be renegotiated. In the early 1990s, I went to a
European Union conference on harmonizing drug policies. What harmonizing
drug policies meant at that meeting was to bring the Dutch in line, and
the Dutch were really being bullied at that meeting.
Now almost a decade later, we see many of the old adversaries of the
Dutch in this battle really moving in the Dutch direction, and as Europe
is changing, Australia, Canada are changing. I think we’re going to
see a movement internationally. Yes, there’s this belief in American
exceptionalism, and it may well be that the American federal government
doesn’t care what other countries are doing. But one thing that is
important is that some of these other ways of dealing with marijuana
will no longer just be hypothetical. We’ll actually have experience
with those and we’ll find out what happens. And so far, as we’re
accumulating evidence, we find out that not much happens. The sky does
not fall in, and I think that that’s potentially important.
David Theroux
Another question for Ed Rosenthal. Where is the tipping point in this
drug war?
Ed Rosenthal
I think the tipping point has already occurred. And the tipping point
has occurred over a period of time as citizens in eight states voted
overwhelmingly for medical marijuana. And when we heard in the polls
that between 60 percent and 75 percent of the population are in favor of
it. We’ve tipped in terms of medical marijuana. And it’s just that
right now the tail is wagging the dog. It’s not going to be happening
for long.
And one of the things that the book The
Tipping Point talks about is that things will go along on a
plateau for a while, but when thing start happening, they happen
quickly. And in our lifetime that’s happened any number of times. One
day we woke up and the Soviet Union was no longer. We had apartheid in
our country. There are a number of major changes. There was no gambling
in this country. There was only one state that had gambling, and now
that’s an accepted practice. So I think that we have actually tipped,
and we’re going to see a rapid change in this, probably with new
administration in Washington. [Applause.]
David Theroux
I have a number of questions, which I’ll direct to the entire panel,
regarding the question, what do individuals with terminal illnesses do
to alleviate pain and who either live in or outside of California --
we’re talking about people with Crohn’s, ALS, and any other ailments
-- if the Feds are breathing down the neck of clubs and so forth? What
can these individuals do? Who can they turn to?
Robert J. MacCoun
Actually, let me give a non-medical opinion on this. I think it’s
extremely hard to justify prosecution of people using marijuana for
medical use. But I think we also have to be clear that the evidence is
that the risk of arrest and prosecution for someone using marijuana
medicinally or otherwise is quite small. The probability of arrest for
all marijuana users in a year of using is about 3 percent, and for
medical patients who are using it medically, that the risk is certainly
lower than that. Basically, there are a lot of people in states without
medical marijuana laws who are already obtaining marijuana and using it.
Anyone else?
David Theroux
Okay, another question for the entire panel. One of the real concerns of
the opponents of medical legalization is the growing use among youth,
but medical marijuana is used much more by people who are older. Can you
comment on this youth-age question?
Donald I. Abrams, M.D.
Actually, I just read, I think yesterday, that as an example of how the
current drug war is not working, that there has been an increase in
utilization of marijuana smoking in sixth graders and eighth graders or
something. Martha Rosenbaum, who is in the audience, knows this a lot
better than I do, and I just heard her speak.
But I think that this question of the gateway drug -- I always quote
whoever it was that said that marijuana is as much of a gateway drug as
caffeine and tobacco. It’s just that people have access to these
things at a younger age, and then, if they go onto other things, it’s
because of that, not because of marijuana leading them to other drugs.
So I think there is a problem with use among youth, but I think we need
to be upfront and discuss it with children.
Ed Rosenthal
Actually, I think that the it’s been shown that some of the federal
commercials, you know those –
Donald I. Abrams, M.D.
Are backfiring.
Ed Rosenthal
They have totally backfired. That they’ve actually given kids an
incentive to use it. [Laughter.] And, well, you know, there was that one
commercial that said that you were the youngest grandparents in the
neighborhood. I mean, I never found that effective that way, but that
might have a certain incentive to youth, and also I think the taboo
factor comes into play.
I have a 12-year-old daughter, and she doesn’t seem to have an
interest in using it. She thinks of it as an adult thing. But I think
when you bring the taboo factor into it, that is a major player in it.
Edwin Dobb
May I say something too? I think, too, that obviously the discrepancy
between what people actually know by virtue of experience, especially
with marijuana, is like we’re living on two different planets.
There’s a group of people who have been involved in this social
experiment now for the last 40 years. A couple of generations have
accumulated wisdom about the use of marijuana now, and it’s completely
at odds with what many policymakers and politicians view. And I think
that discrepancy, if it’s promoted in terms of education and anti-drug
programs, just fosters a cynicism and a disbelief in those very
officials, because they’re so out of touch with the reality of a drug
that’s now so widespread, on a recreational level, that simply, for
many people, it’s just part of the woodwork now. It’s part of the
climate we live in. And I think that has an erosive effect.
Ed Rosenthal
One more thing. You know, from reports in the newspapers, Bush’s own
daughters don‘t believe the rhetoric. [Laughter.]
David Theroux
I think this would be also a question for Dr. Abrams. What research is
planned or has been completed about the addictive influence of HIV
medicines on cannabis users? It’s a reverse question.
Donald I. Abrams, M.D.
Addictive? I’m not aware of -- I’m not sure I understand that one at
this point.
David Theroux
For the entire panel, the question is, please talk about SB420 and what
it means, if it’s passed? This is regarding the issue of plant limits
for individuals, and co-ops, and so forth.
Ed Rosenthal
Okay, SB420 is the Vasconcellos Bill that we were talking about, and
what that bill would do is set a certain minimum for counties, because
right now in California, effectively, medical marijuana legalization is
county by county. In some counties, they say you can grow a large number
of plants or posses a large amount. In other counties, it’s a very
small amount, and this bill would set certain minimum standards.
Counties could adopt other standards, but this would set a floor on
them, and it’s six plants in a certain amount of space. But it also
provides for more medical research.
And so the medical marijuana community is really divided on whether this
bill should be signed by the governor or not, because Lockyer’s office
-- the attorney general’s office -- put such limits on the number of
plants that it would be difficult for some patients to grow enough to
supply themselves.
Robert J. MacCoun
Just by way of comparison, in Alaska there’s a state supreme court
decision that interprets their privacy provision in their constitution
as allowing up to 25 plants, not for medical use but for anyone to grow
up to 25 plants, just to put it into context how low this limit is.
Ed Rosenthal
Well, let me get into this for just one moment. Marijuana flowers based
on the number of hours of uninterrupted darkness that it has. So you
could take a plant that’s this tall and flower it, or you could grow a
plant for six months, where it’s 12 feet tall or something before
flowering it. So plant size is not a real accurate method of describing
the volume or the quantity or yield that you’re going to get. And
there are much better methods using either canopy space, or the number
of lights.
So, this is just cop jargon where they say, “Oh, he had a thousand
plants,” and everybody’s picturing these giant plants that are five
feet breadth and ten feet tall. The way I was cultivating mother plants,
they were in a three by three square foot area. There were 24 plants. I
mean, they were very small plants, so to use a plant count is really not
an accurate method of describing marijuana.
David Theroux
Another question for the entire panel. Do you feel the average
recreational pot smoker ultimately helps or hinders the legitimacy of
medical marijuana?
Robert J. MacCoun
We could interpret that as a question of moral philosophy or as a
question of politics. I think from a political perspective, it probably
cuts both ways. The existence of recreational users certainly creates
the possibility that somebody might be pretending to have a medical
condition to get marijuana, and that’s always the caricature that’s
held up.
In fact, a third of the American adult population has tried marijuana
without a prescription, and so it cuts both ways because, in fact, you
have so many American adults who’ve tried marijuana that I think
it’s shaping their political views. And I think that’s one of the
reasons why, for the first time in several decades, we’re starting to
see a shift in public opinion about marijuana.
Ed Rosenthal
But on the other hand, a lot of people who think that they’re using
marijuana recreationally are actually using it medically, in the same
way that a person might come home and have a drink after work, as a
stress release, or as a life enhancement. And, in fact, my doctor told
me I’m supposed to have three glasses of wine a day. Luckily, I
don’t do it. So there is a lot of use that people might consider
recreational, but is actually, really, life enhancing or medical use.
David Theroux
Another question for Ed. In a Chronicle op-ed piece, you lamented
your ability to vote now that you are a felon. Letters responded that
you are wrong. You still can vote. Please comment.
Ed Rosenthal
That’s true. I learned that I was misinformed by my supervisory
officer about my voting status, and I do plan to vote. [Applause.]
David Theroux
I hope everyone notices the irony of that. Here you have a jury not
informed, making the wrong decisions. He gets convicted. His parole
officer doesn’t even know his own rights. Another question for the
whole panel. Are there good numbers of the extent of police budgets as
they become more and more dependent upon asset forfeiture?
Robert J. MacCoun
If you go to Google and you type in “Albany Source Book on Criminal
Justice Statistics,” you can all look them up for yourself. It turns
out that there is an increasing database now on this, and just to sum it
up qualitatively, it’s becoming an important source of income for a
lot of agencies, and which, of course, creates a serious conflict of
interest.
David Theroux
Another question for Ed. Do you think it will take a national vote to
make marijuana legal?
Ed Rosenthal
I think that in order for the Democratic Party to win back the
presidency, it has to come out at least in favor of medical marijuana.
[Applause.] And you would think that was a no-brainer for the
candidates. Marijuana wins by wider margins than they do. [Laughter.]
David Theroux
Other questions for Don Abrams. Are there studies regarding marijuana
and menopause? Do people develop tolerance, either physical or
psychological, to the effects of marijuana? Are there significant
reaction times and motivation to marijuana use? How does it change? The
different types of people and degree of usage and so forth.
Donald I. Abrams, M.D.
Well, I don’t know of studies that are currently ongoing on women with
menopause, but I’m sure menopausal women have their own anecdotal
experiences, so I don’t know the answer to that. With regards to
tolerance, I’m not really a substance specialist in this fashion.
I’m an AIDS and cancer doctor, so I don’t really know all these
details, but I do believe that enzymes get inducted as equal smoke, and
you might need more or less marijuana depending as time goes on. The
other questions, they sort of went by me too quick, and I don’t have
answers to them anyway. [Laughter.]
David Theroux
A question for Ed Dobb. The recent Supreme Court decision striking down
laws against homosexual sex appear to open the window toward protecting
privacy and liberty. Do you see an opening for drugs and cognitive
liberty?
Edwin Dobb
This goes back a little bit, if I understand the question, to the
tipping-point question earlier. I honestly take an extreme position in
terms of legalization, or at least the cessation of government intrusion
into private behavior. I don’t foresee a tipping point regarding any
of the more serious drugs, or the drugs we take more seriously any time
soon, if ever.
My deepest concern is that various crises are used, be they related to
drugs or not, to expand police powers, and once they are expanded, and
the crisis is over, whether it’s manufactured or manipulated, the
police powers are not automatically withdrawn. We sort of take that as a
given, and there’s a cultural shift going on.
In fact, I was thinking as we were talking about gateway drugs. There
are sort of gateway steps to intrusion on civil liberties, and that’s
what concerns me about the overall atmosphere in which we discuss this
thing. Obviously, we’re not going to legalize cocaine and heroine any
time soon, but I think, in our debate about that, we should be very
concerned about any change, any expansion, in terms of police powers,
because then it can be used for anything, not just drug use, but any
kind of personal behavior, and I think that’s why we’re all at risk.
We all have a stake in what’s happened to Ed, and it’s all our
responsibility to at least be vigilant and aware, and to do what we can
to make sure that the state does not expand police powers.
David Theroux
There’s a question for Ed. The Medical Board of California is claiming
that Dr. Tod Mikuriya, a Berkeley psychiatrist, has violated a
“standard of care” in 17 of 7,500 medical marijuana recommendations.
Mikuriya notes that all 17 cases involve patients who have been targeted
by law enforcement. He claims the state law enforcement officers for
Prop 215 are trying to intimidate doctors like him and prevent patients
from getting medical, medicinal cannabis. Do you feel this is true?
Ed Rosenthal
When they say the California Medical Board -- it’s Californian and
it’s a board, but its not medical; it’s out of the district
attorney’s office. And these 17 cases were complaints, not by
patients, not by their caregivers, not by their loved ones. Every one of
the complaints against Dr. Mikuriya is by police officers or
prosecutors.
And my attitude towards this is that I promised not to call a doctor if
I have a robbery, and they should stay out of [laughter and applause] --
and the police and the so-called medical board -- you know, this medical
board is really there to investigate doctors’ fraud or pill pushers,
and things like that. And the fact that they’re using it in this
politically motivated thing, it denigrates the entire attorney
general’s office. And as a result of this, I call on Lockyer to resign
from this. Really. [Applause.] He’s too much -- he’s not in the
hands of the people. He’s not representing the people. He’s
representing a small clique of verbal terrorists who are members of the
California Narcotics Officers Association.
David Theroux
It’s a question’s for Don Abrams. Any evidence that marijuana or THC
can have a beneficial effect on depression? (Like being depressed about
the laws.)
Donald I. Abrams, M.D.
Clinical trials have really not been done about that. I think there’s
interesting information about schizophrenia. There are some people who
believe that schizophrenia may actually be responsive to marijuana and
that some adolescents who have so-called schizoid personalities tend to
be ones who use more marijuana -- and it’s one of the chicken and the
egg questions. Are they schizoid because they’re smoking marijuana, or
are they smoking marijuana because they have schizotypal (as
psychiatrists call it) tendencies?
Depression -- it’s an interesting question for those of us who are
caring for patients who are dying for whom marijuana can provide many
different medical benefits, including relief of pain, increase of
appetite. There is also what people who are sort of funny about their
opinions about marijuana call the side effect of euphoria, and is that
an adverse side effect for people who are depressed, or for people who
are dying?
I think not, so I think some people actually do get more depressed
though after smoking marijuana. I know many people in my generation, in
fact, claim that they’ve stopped smoking marijuana because it seemed
to depress them a bit.
But I think a buzzword now in medicine is pharmacogenomics, and it means
that we all metabolize drugs differently, depending on our genetic
make-up. So I think to make a blanket statement about depression and
marijuana is not possible, and it probably goes both ways.
David Theroux
Another question for the entire panel. Please discuss the role of
science and law enforcement with respect to possible harm to others from
using marijuana, e.g., driving under the influence, and the individual
health effects, possible carcinogenic effects of smoking marijuana that
individuals should be informed of.
Robert J. MacCoun
Yes, there are several lines of evidence on this question. One is by
looking at motor vehicle mortality data. There is some correlation with
marijuana use, but when you look closely at it, it mostly involves cases
where the person was also under the influence of alcohol, and the
alcohol effect was probably acute. The marijuana effect is less certain,
because marijuana stays in your bloodstream for up to a week, and so
they’re probably measuring alcohol rather than marijuana.
A more direct way of testing is to put people in. They set up in a
parking lot these little driving tests and have people drive under the
influence of various substances. And marijuana does impair psycho-motor
coordination, but that’s largely offset by the fact that marijuana
drivers drive more slowly. [Laughter.]
And before he passed away, the late Pat Paulson, the comedian who ran
for president every four years -- I emailed his campaign headquarters
and got a quick response from him, because I think he is the campaign
staff, or was the campaign staff. I asked him, where his office stood on
the question of legalization of marijuana. He said, “I’m against it
because it makes people drive too slow.” [Laughter.]
I’m making a joke, but I don’t want to trivialize this. It’s not a
good idea to operate heavy machinery when you’re stoned, obviously.
But it exemplified something that I’ve seen again and again. From all
the research trying to document harms of marijuana, what I’m struck by
is that there are tremendous professional rewards for finding harms of
marijuana, and there are a lot of people out searching very
aggressively.
And I see a standard of evidence that is used that is quite different
from the standard of evidence I see in other areas I work in, and I find
it quite troubling. I see extremely weak effects getting really trumped
up. I see interpretations by NIDA-funded scientists that are not at all
supported by their studies.
Just as a quick case in point, so-called animal evidence for a gateway
effect is extremely indirect. One study that supposedly implicated a
link between marijuana and morphine was based on gnawing movements by
rats, when they take marijuana, and they counted nine movements.
Something they didn’t do, which would have been obvious to do, is
simply give rats THC and see if they’re more likely to self administer
cocaine or heroin. I can’t find any study that’s actually done that
in the literature. Obviously, that’s what you would do if it was a
gateway effect, and I have to assume that if you could do it, they would
have found it by now.
And so marijuana is not harmless. It’s also not as harmful as the
government is telling us.
Donald I. Abrams, M.D.
Can I address cancer for a second? The national toxicology program of
the Department of Health and Human Services did a study in rats and
mice, which they delayed the publication of by two years, until we
discovered the draft copy, and asked them where the final one was.
The study gave rats and mice increasing dosages of delta9-THC which is
synthetic -- the compound that is most psychoactive in marijuana. And
what they found was that the rats and mice who got higher dosages
actually lived longer and had fewer malignancies.
Rats and mice are not people, however, so Steve Sydney, who is a medical
school colleague, a classmate of mine, and also the director of research
for the Kaiser Foundation in Oakland, published in the American
Journal of Public Health an overview of men in the Kaiser system who
were followed for at least 10 years, divided into four different groups
of 5,000 men per group. One group never smoked cigarettes or tobacco.
One group smoked only tobacco. One group smoked marijuana or tobacco,
and the other group smoked both.
Over 10 years of follow-up of 5,000 men who never smoked either tobacco
nor marijuana, there were two cases of lung cancer. In the groups that
smoked tobacco, either alone or with marijuana, the risk of lung cancer
was increased 13 fold, which is the risk of cigarette smoking. In the
group that smoked only marijuana and never tobacco, there were zero
cases of lung cancer.
Now zero compared to two, it’s a small number -- you can’t say
anything statistically -- but certainly it did not appear to increase
the risk of lung cancer. And if we look at Rastafarians in Jamaica, for
example, a population that uses marijuana extensively for religious and
cultural purposes, there is no increased risk of lung cancer. There have
been people who have published studies suggesting that there is
increased head and neck cancer, and for unclear reasons perhaps prostate
cancer, but I believe that these studies are probably flawed and there
are other co-factors that are accounting for these malignancies.
David Theroux
Another question for the entire panel. Are you familiar with LEAP, Law
Enforcement Against Prohibition?
Donald I. Abrams, M.D.
Yes, I just got a T-shirt from them someplace. [Laughter.] And it’s a
good one.
Ed Rosenthal
Yes, there are a lot of police officers who are really concerned with
this. Either they know better, or they see the police force being
corrupted by it, and pretty much LEAP members are ostracized by the
criminal justice community.
David Theroux
If a person is a patient in the hospital and has a medical marijuana
prescription or ID card, can they possess and/or use their marijuana
while in the hospital?
Donald I. Abrams, M.D.
Most hospitals are currently no smoking facilities and that holds for
marijuana. We have, at San Francisco General, a certainly much more
extensive use of substances besides marijuana that goes on at our
campus, but we do have a little courtyard on the third floor of the
hospital outdoors where patients do go to smoke cigarettes, and I’m
sure that some of my chemotherapy patients have been seen there as well.
Ed Rosenthal
One thing is that smoking marijuana is pretty much an artifact of
Prohibition, and so there are many other ways for marijuana patients to
receive it. They can use a tincture, which they use sublingually under
the tongue, or brownies, pills, and other ways of -- vaporizers. So
people don’t have to smoke it.
For instance, let’s say you were in the theatre and you wanted to
light up, and that would disturb people around you, but if you just have
a tincture and you put a few drops under your tongue, it would disturb
nobody.
Donald I. Abrams, M.D.
Our research is done in San Francisco General Hospital, and to equip the
room in the general clinical research center, we had to put a fan in the
window that exhausted to the outside. Unfortunately, being San Francisco
General Hospital, the door to the patient’s room to the hallway is
about an inch above the floor, so nurses, when the patients are smoking,
have to roll up a blanket and put it outside the patient’s door, sort
of the reverse of college. [Laughter.]
David Theroux
There are a number of questions that relate to one of the points that Ed
Dobb made in his presentation. If marijuana were legalized and taxed,
couldn’t that be a major source of public revenues? And there’s
different ways of looking at it. One point before I pass it to Ed is
that when the Harrison Act was first passed, it was actually an excise
tax on opiates, and the tax then created a black market, and to enforce
black market contracts, different groups, of course, used draconian
means. Meaning a lot of crime rates went up, and the solution to that,
allegedly, was to ban these different substances. There’s more to it
than just that, but that’s essentially what happened. And as Ed also
mentioned, a similar kind of thing happened from the 1930s on, as far as
when Prohibition was lifted on alcohol, marijuana was taxed, and then
ultimately banned.
So anyway the question is, what would happen if marijuana were legalized
and taxed? Is that anyone?
Robert J. MacCoun
Well, we take that up in the book Drug
War Heresies, and we identify some serious drawbacks to any
retail sale and taxation model. Legalization would almost certainly
reduce prices. Public health and drug policy forces would strive to
increase the tax to reduce any increase in use. That could generate a
lot of revenue. But if the tax is too high, you recreate the black
market, as Canada learned when they tried to steeply raise their tobacco
taxes. Also, commercial interests would lobby hard to resist steep
taxes.
Moreover, there are several lines of evidence that commercialization
will lead to steep increases in use -- increases the general public is
unlikely to be willing to risk. I think if we were going to move some
sort of legal model, there are a lot of advantages to a home cultivation
model rather than a retail and tax model. A model of legal home
cultivation would probably produce less of an increase in use, and would
help to separate the marijuana and hard drug markets.
Ed Rosenthal
I think of it more as a tomato model. [Laughter.] And what I mean by the
tomato model is this. Actually, if you’re going to grow a vegetable
garden, you’re most likely to grow tomatoes. And there are more
tomatoes grown, and eaten, and consumed that are homegrown than are
grown commercially in the United States, but there still is a very large
commercial tomato market.
And I think that most people aren’t going to want to grow their own.
They don’t have the space, or the time, or they just use a little bit,
or they use it once in a while, and those people have no incentive to
grow their own. They really just want to go and purchase it. And on the
other hand, there are a certain number of people who are going to want
to do it.
Now, there was a book that covered abortion and the cost, it was called,
Baseball, Abortion, and Prohibition, I think, and when abortion
became legal, the cost of an abortion went down by about two-thirds.
When alcohol was re-legalized, it went down by about 50 percent.
So if there was a legalization model that had a certain amount of excise
tax in it, the market would absorb it because people are paying that
excise tax in terms of the risk. If a person buys an ounce of marijuana
right now, they’re paying a certain amount for the cost of
manufacture, and distribution, and so on, and then they’re paying an
extra price for the risk that the grower is taking. And the taxes would
fall somewhere in between and would take some of that risk money as an
excise tax, and that’s typical. Take cigarettes as an example. There
is a certain amount of cigarette smuggling, but the overwhelming
majority of cigarettes that are sold in the United States today are
taxed.
Robert J. MacCoun
Well, when we took a look at the home cultivation model, it hadn’t
occurred to me that home cultivation might be addictive, and that does
raise some concerns. [Laughter.]
David Theroux
I’m afraid we have time for just one last question, and this is for
the whole panel. And this relates to the point that was mentioned
earlier, that all the major candidates in the recall election have
endorsed medical marijuana. What can a new governor of California do to
stop a federal campaign against medical marijuana?
Ed Rosenthal
I think that the new governor could comment and use the state resources
to defend medical marijuana users and their suppliers, and say, “Well,
if the federal government is coming in, we’re going to defend these
people,” and I think that the federal government would back off
because they’d never, ever be able to get a conviction again.
[Applause.]
Robert J. MacCoun
I think if a state politician, especially a governor, really started
contesting the federal government on this, I think it would really be a
very serious political consequence for the federal government and would
really risk underlying support for the federal government’s position
on marijuana. This is truly remarkable that we have all these candidates
endorsing medical marijuana. When we wrote our book, we couldn’t find
any politicians in office to cite as being in favor of marijuana reform,
other than Mark Morial, the mayor of New Orleans at the time, and Kurt
Schmoke, the former mayor of Baltimore. Otherwise there were no
politicians on record as favoring reform of any kind.
David Theroux
I want to thank Ed Rosenthal for his superb work and surely courageous
leadership. We’re indebted to Ed, and as Ed has said, it’s just a
matter of time. I also want to thank our speakers, Donald Abrams, Edwin
Dobb, and Robert MacCoun for their really excellent presentations and
taking their time to join us for this program tonight.
We’re especially grateful to our co-sponsors, Harper’s Magazine,
the Drug Policy Alliance, and the Goldman School at U.C. Berkeley for
their marvelous assistance, and most of all, I want to thank each of you
for joining with us. Without you this program wouldn’t have been such
a success and the movement that we’re discussing could not possibly
succeed.
As I mentioned earlier, Ed and Rob will be available in the outer lobby.
We hope that each of you will pick up copies of their books, Why
Marijuana Should Be Legal and Drug
War Heresies. Anyone seriously interested in this issue cannot
do any harm by reading their books, to say the least, so I strongly
encourage you to get them. They’d be happy to autograph them for you.
Please also visit our website, Independent.org for upcoming information
about our events. We look forward to seeing you at our next Independent
Policy Forum. Thank you and good night. [Applause.]
Newshawk: Paul Armentano - http://www.norml.org/
Source: Independent Institute (CA)
Published: October 02, 2003
Contact: info@independent.org
Website: http://www.independent.org/
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