DRUG TRIAL: The MEDICAL MARIJUANA MENACE

California and Arizona voters changed the politics of the drug war when
they approved "medicalization" ballot initiatives in 1996. Both reformers
and prohibitionists have had to deal with the consequences.

On the reform side, as the movement begins to mature and achieve a tangible
success here and there, we are seeing internal debate and factionalization.
For years the movement has functioned amorphously, with a "big tent"
mentality and a lot of preaching to one another. Nowadays, those of us
working on medical marijuana initiatives for the 1998 ballot seem to catch
flak from every angle. Repeal advocates tell us that medical marijuana does
not go far enough. We are also criticized for how we would permit medical
marijuana - with regulation rather than declarations of complete freedom
for doctors and patients - and for limiting it to certain medical conditions.

At the same time, the 1996 votes have helped remind reformers of our common
enemies. When an issue like allowing some patients to use marijuana,
seemingly so peripheral to the broader drug policy debate, causes a panic
among the drug war's partisans, it is worth asking why. One way of
addressing that question is to speculate what might happen if voters
approve every state initiative on medical marijuana (a total of four to
six) this November. Could we expect anything like the over-the-top,
multi-agency roar federal officials let out in 1996? If so, perhaps the
drug warriors will further erode their credibility by fighting public
wishes and denying patients a useful medicine.

Alternatively, the federal drug warriors might give in on medical
marijuana, moving it to Schedule II or III so doctors could prescribe it,
and thereby put a "friendly face" on prohibition, exactly as Thomas Szasz
fears. The multi-state initiative strategy is designed, in part, to force
or facilitate the rescheduling of marijuana, with the underlying risk of
relieving pressure for reform. If federal officials choose to build a
firewall behind medical marijuana, but in front of legalization, hopes for
repeal of prohibition would dim.

But is it really plausible that the guardians of prohibition would make
that move? The ban on medical use of marijuana is rooted in the
restrictions established by the 1937 law that banned recreational use, a
mistake Congress failed to fix when it rewrote the drug laws in 1970.
Compelling studies of marijuana's therapeutic potential in the late 1970s
and early '80s did not affect federal policy, so it is difficult to believe
today's proclamations that science will resolve this issue. The evidence
suggests that the drug warriors believe prohibiting medical use is crucial
to the overall policy of intolerance toward marijuana.

If the problem is ideological, it may be impossible to get a concession.
The never-ending frustration of medical marijuana advocates is that the
drug war can't seem to accommodate a modest reform like making cannabis
available by prescription. By the same token, such a reform could be
devastating to the war on the drugs. That, at least, seems to be the
understanding of hard-core drug warriors.

Whatever the federal reaction, the fight for medical marijuana offers
benefits that abolitionist critics often overlook. In addition to being a
compassionate step in itself, changing state laws on medical marijuana
tends to put the right issues into play and the right people on the
defensive. It raises questions about the nature of drug prohibition and the
rationality of its enforcers. It enhances the credibility of reformers and
attracts allies who may ultimately be persuaded to support more radical
change.

With those benefits in mind, medical marijuana initiatives should neither
stoke nor calm fears about the medicalization of drug policy. Permitting
the medical use of marijuana does not, as Thomas Szasz has written in
Liberty, endorse the "fiction that self-medication is a disease" or declare
"punishing it a treatment." The mechanism for allowing medical use is to
carve exemptions into existing criminal laws. That seems to reduce the
power of the state, especially since it forces those charged with
implementation to change their tactics, sometimes fundamentally. Police in
California, for example, are learning that marijuana they seize may be
someone's medicine, in which case they have to give it back.

If opponents of the drug war want to have an impact, rather than focusing
on the perfect policy or waiting for revolutions in the public's thinking,
we have to reach out to new people, find working compromises, and advance
concrete proposals. Proposals rooted in medicalization concepts currently
have the greatest public appeal, notwithstanding the recent vote in
Washington state. The more moderate and sensible our proposals seem, the
better our chances of success. At the same time, if it is true that any
successful challenge to the drug war, even on a relatively narrow issue,
threatens an overly rigid paradigm, so much the better. We can't count on
overthrowing the generals with modest peace offerings. But in the very
strange world of U.S. drug policy, it just might happen.

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