Pot and Politics: Investigating Barriers to Medical Marijuana Legalization

Alex Beck was in his early twenties when he was diagnosed with stage three lymphoma. After he experienced debilitating side effects from the chemotherapy drug Rituximab and made no progress in treating his cancer, Beck turned to holistic medicine through a Facebook group called The Medicine Tribe. The organization raised three thousand dollars to send Beck cross country to Colorado where he stopped chemotherapy entirely and used only cannabis in an attempt to cure his cancer.

Two years later, Beck continues to baffle doctors at Stanford University, “The doctors said that there is absolutely no reason, with the little amount of chemotherapy I received, that I should still be in remission … I should have malignant tumors, but my PET scan showed no signs of disease.”

Beck’s story is just one of many cases of individuals being cured of numerous ailments by using  cannabis, and anecdotal evidence has been bolstered by academic research. Cannabis has been shown to assist in the treatment of childhood seizure disorders, some cancers, muscle spasms, nausea, eating disorders, arthritis, and multiple sclerosis. This research, however, has been limited and obstructed by marijuana’s status as a federally illegal substance. Beck told the HPR that cannabis’ federal status has created tense, even dangerous conditions for researchers, explaining that, “If you release any information on the research you’re doing, you can get arrested.”  Regardless of the potential legal repercussions, researchers appear to have made a convincing case, with 76 percent of doctors now favoring the use of medical cannabis.

Support for the healing capabilities of cannabis extends beyond the medical community. According to a 2017 Quinnipiac poll, the American public recognizes the benefits of marijuana, and 94 percent of voters favor medical marijuana legalization. Furthermore, 29 states legalized medical marijuana before the start of 2018. Public support has not, however, been sufficient in garnering legal approval, with medical marijuana remaining illegal at the federal level. The Drug Enforcement Agency’s interference and the Food and Drug Administration’s complicated approval system have contributed to the problem.

Bureaucratic Barriers

Medical cannabis’ path to federal approval has been obstructed by bureaucratic opposition to research, stemming from the FDA’s failure to approve marijuana as medication. The FDA claims to have no issues with approving medical marijuana, so long as it is done using proper clinical research. The obstacles to marijuana legalization arise not from FDA attitudes towards the drug, but rather from the approval process itself.

FDA approval begins with companies submitting Investigational New Drug Reports for clinical trials of new medications. The FDA then has 60 days to review and approve the trial. The Center for Drug Evaluation and Research, a research center controlled by the FDA, reviews the work done by outside agents, then makes recommendations on labelling and dosages to the FDA, with the FDA itself conducting no actual studies.

Because the FDA relies on outside research firms, cannabis research is at the mercy of state laws. Marijuana’s status as a federally illegal substance makes clinical trials extremely difficult, if not impossible to conduct, hence barring any possible FDA review and approval.

In the fight for marijuana legalization, the Drug Enforcement Agency poses an even greater barrier than the FDA, as it has routinely blocked research efforts. University of Massachusetts researchers have battled the DEA for over a decade to get a permit simply to build a cannabis research facility, let alone enter into the human clinical trial testing required for FDA approval.

This conflict arises primarily from marijuana’s classification by the DEA as a Schedule I substance. Schedule I substances, according to the DEA, have “no currently accepted medical use and a high potential for abuse.” On the current scheduling system, marijuana is ranked as having a higher potential for abuse than cocaine, methamphetamines, and oxycodone, all Schedule II substances; It is even ranked as having a higher potential for abuse than cocaine, which is ranked as one of the top five most addictive drugs and the third most damaging drug.

The major hypocrisy of this scheduling is government held patent number 6630507, which recognizes that cannabis has medicinal properties. The legal US document states that cannabinoids, organic components of marijuana plants, have “particular applications” in preventing neurological damage after trauma, treating neurodegenerative diseases like Alzheimer’s, and treating autoimmune diseases. This government patent acknowledges numerous health benefits derived from cannabis. The very same government that holds this patent classifies marijuana as a substance with “no currently accepted medical use,” showing DEA scheduling is not only prejudicial, but contradictory.

Big Pharma, Big Problem

DEA obstruction is given validity through marijuana’s status as a federally illegal substance, which is supported by anti-marijuana lobbying. The pharmaceutical industry contributes more to lobbying activities than any other industry, spending 2.6 billion dollars on lobbying between 1998 and 2012. This massive effort has a clear motive behind it; recent estimates speculate that major pharmaceutical companies stand to lose 18.5 billion dollars in profits if medical marijuana becomes legal in all fifty states.

Much of this profit loss would be generated from opioids and prescription painkillers, as medical marijuana has been confirmed to relieve pain disorders. In states where medical marijuana is legal, there has been a 24.8 percent decrease in fatal opioid overdoses on average. Moreover, in states that have legalized medical cannabis, there has been an average decrease of 11 percent in general prescription drug usage. The potential for medical cannabis to treat pain may even assist in ending America’s opioid crisis.

Painkiller manufacturers have been quick to take notice of falling prescription rates and attempt to counteract them. Purdue Pharma and Abbott Laboratories, the companies that produce OxyContin and Vicodin, are two of the largest donors to the Partnership for Drug Free Kids, one of the largest anti-marijuana lobbies. Purdue Pharma also donates to Community Anti-Drug Coalitions of America, while Abbott Laboratories is the second largest pharmaceutical donor to congressional representatives.  

Law Enforcement Lobbying

Though Big Pharma stands as one of the most economically well equipped opponents of cannabis legalization, contrary to popular belief, law enforcement may bear an even stronger influence.

Paul Armentano, the Deputy Director of the National Organization for the Reform of Marijuana Laws, revealed to the HPR that he believes the influence of law enforcement agencies to be even greater than that of pharmaceutical companies. Armentano remarked that if congressional representatives were being unduly influenced by any industry, it would be law enforcement, which has been “far more prolific and consistent in their public opposition to this issue than any other special interest group.”

Armentano noted that politicians “speak the language” of law enforcement groups and “trust the message that they’re going to be hearing” from law enforcement representatives. While law enforcement influence is about credibility, from a political standpoint, endorsements may matter more. “Most people seeking local or state political office seek the endorsements of the local sheriffs, of the local DAs, of the judges,” said Armentano, “They’re not going to tick off that constituency that they need for election by opposing them on drug policy reform.”

The power of the purse, however, has not been lost on the private prison industry. One in five inmates in the US prison system are incarcerated for nonviolent drug offenses. Federal legalization of cannabis stands to cut into the rate of incarceration for drug crimes, cutting profits for private prisons by decreasing the supply of incarcerated persons. Corrections Corporation of America, one of the largest private prison companies in America, now CoreCivic, collected 195 million dollars in profit in 2014; that same year, CCA spent over one million dollars on anti-marijuana lobbying alone. CCA even stated in a 2014 regulatory report that, “[A]ny changes with respect to drugs and controlled substances or illegal immigration could affect the number of persons arrested, convicted, and sentenced, thereby potentially reducing demand for correctional facilities to house them.” Industry concerns over marijuana legalization is not for potential health risks, but rather a concern for potential profit loss.

Follow the Money

Responsibility for medical marijuana legalization ultimately lies in the hands of Congress. Medical marijuana legalization has been painted as a morally enigmatic threat to public health, however, the motivation behind the anti-medical marijuana movement can be discovered not when one follows the morals, but rather the money. Elected officials have been lavished with more money from Big Pharma than any other industry since 1998, with contributions spread roughly evenly between parties. Democrat Barack Obama received more money from Big Pharma than any other political candidate in 2012; Republican Mitt Romney followed closely in second place.

According to a 2017 Quinnipiac poll, 94 percent of Americans favor medical marijuana legalization. Those who most strongly oppose it are not concerned citizens, but industries standing to lose profits. Prescription medications churned out by Big Pharma were responsible for 52 percent of all deaths caused by overdoses in 2015. Meanwhile, pharmaceutical companies have dedicated billions to preventing the legalization of cannabis, a competitive substance that has never been responsible for a fatal overdose.

Jon Marsh, a former US Marine and leading cannabis activist, lays the blame for prohibition on Congress as well. Marsh has been using cannabis since 1993 to alleviate Gulf War Syndrome, a medical condition that causes chronic fatigue, muscle aches, and mood disorders such as anxiety and depression. Marsh commented in an interview with the HPR that cannabis prohibition is about, “following the money trail.” For Marsh the money goes deeper than just lobbying. As he explained, “Big Pharma will only be able to control the plant if the US Government allows them to do so. And thus far, [the government has] directly aided pharmaceuticals.” Marsh sees Congress as Big Pharma’s financially motivated enabler, commenting that many congressional representatives have “stocks and futures in the very products and services which cannabis, and hemp, will compete with.”

Marsh similarly pardons law enforcement officials, including Attorney General Jeff Sessions, since Sessions is just doing his job as the US Attorney General. He doesn’t blame Sessions for cracking down on marijuana, but Congress for giving him the authority to do so: “If Congress got together and simply repealed the horrific legislation … Sessions could focus his attention elsewhere.”

Greener Days Ahead

Though medical cannabis faces numerous obstacles to federal legalization, advocates see a path to constructive policy change appearing in the coming years. With striking results from public opinion polling and continued research progress, activists are becoming increasingly hopeful for federal legalization. Marsh is one of these activists who is not yet ready to give up the fight, “By 2020 I see a shift where pro-cannabis will be a thing to be …. The future is going to be very bright, how bright depends on the legislators moving forward in 2020.”

Beck took a slightly different approach to the question of this brighter future, instead placing the responsibility on the American public itself. “The best way to start is to have local communities band together and decriminalize on a county to county basis. Once enough counties do that, the state and federal governments will see that the people are speaking. They will hear us.”

Though congressional representatives may hear their constituents, the question is whether they will listen. Contrary to popular belief, medical marijuana legalization is not a partisan issue, and for the majority of Americans, is not a moral issue. It does, however, raise fundamental questions about the nature of a republic where representatives answer to the highest bidders rather than constituents. The question of cannabis legalization forces representatives to make a choice, testing where their loyalties lie. Only time can predict whether that loyalty will shift back into the hands of its rightful recipients: the American people.

Image Credit: publicdomainpictures/Laurie Avocado

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