The media might characterize cannabis-reform advocates as college students, long-haired hippies and washed-up rappers, but historically speaking, the primary force opposing prohibition has been medical doctors. In fact, the correct characterization of prohibition is a clash between doctors and bureaucrats.
“There's always been this tension between the people on the front lines who recognize the need to treat patients with the respect afforded to medical needs and the people interested in launching crusades demonizing, criminalizing and generating a political rallying cry,” says Dr. Sunil Aggarwal, spokesperson for Doctors for Cannabis Regulation (DFCR). “That fight happens whether you're a doctor or not a doctor. It's whether you're trying to serve a different aim.”
Flashback to the Marihuana Tax Act of 1937, the first piece of legislation criminalizing cannabis. Arch-prohibitionist Harry Anslinger, who claimed cannabis made people maim, rape and kill, led the propaganda charge testifying before the powerful Ways and Means Committee. His opposition was Dr. William C. Woodward, legislative counsel representing the American Medical Association (AMA).
“Most physicians would want to preserve the right to use [cannabis],” Woodward testified in 1937. “To say, however, as has been proposed here, that the use of the drug should be prevented by a prohibitive tax, loses sight of the fact that future investigation may show that there are substantial medical uses for cannabis.” Woodward complained that, “We cannot understand yet, Mr. Chairman, why this bill should have been prepared in secret for two years without any intimation, even, to the [medical] profession, that it was being prepared.”
The politicians ignored the medical doctor because, ultimately, the medical science didn’t matter. Dr. Barney Warf, a professor at the University of Kansas, explains, “[Prohibition] was not a bottom-up groundswell of people terrified that cannabis was destroying their communities because it didn't happen. It was a top-down, carefully and conscientiously manipulated panic, what sociologists sometimes call a ‘moral panic,’ where a frenzy is whipped up for opportunistic reasons. The whole war against cannabis was entirely a political campaign to serve the interests of an entrenched bureaucracy whose bread and butter was prohibiting drugs. It had nothing to do with its health effects or its medical consequences.”
Despite the medical testimony, round one went to the bureaucrats.
Several years later, Anslinger testified before Congress again to help shape another piece of drug legislation, the Boggs Act of 1951. In response to a spike in opiate addiction rates, the federal government sought to impose mandatory minimum prison sentences for heroin and opium crimes as a punitive deterrent. Anslinger, who famously said cannabis is worse than opium, wanted the congressmen to include mandatory minimums for cannabis. His Reefer Madness-style propaganda had lost its credibility, so Anslinger switched to the stepping-stone theory (or gateway drug theory) saying most cannabis consumers quickly graduated to intravenous heroin use.
The opiate addiction data came from the Addiction Research Center, and guess who opposed the inclusion of cannabis in the new law? Dr. Harris Isbell, Director of Research at the Addiction Research Center. We bet you saw that coming.
The acclaimed researcher argued, “Marijuana smokers generally are mildly intoxicated, giggle, laugh, bother no one, and have a good time. They do not stagger or fall, and ordinarily will not attempt to harm anyone. It has not been proved that smoking marijuana leads to crimes of violence or to crimes of a sexual nature. Smoking marijuana has no unpleasant after effects, no dependence is developed on the drug, and the practice can easily be stopped at any time. In fact, it is probably easier to stop smoking marijuana cigarettes than tobacco cigarettes.”
Despite Dr. Isbell’s ardent medical testimony, round two also went to the bureaucrats.
Fast forward another two decades to the Controlled Substances Act (CSA) of 1970. The year previous, the U.S. Supreme Court deemed the Marihuana Tax Act unconstitutional, but President Nixon quickly responded with the CSA, which created various drug schedule classifications. Per the CSA, wholly prohibited Schedule I substances are very dangerous, highly addictive and without any medical value whatsoever. For the sake of comparison, Schedule I drugs include heroin, acid, peyote and a psychedelic secretion from rare toads called bufotenine, while less-restrictive Schedule II substances include coke, crack and crystal meth.
Congress “temporarily” made cannabis a Schedule I substance as it waited on findings from the newly formed National Commission on Marijuana and Drug Abuse, more commonly called the Shafer Commission. This investigative group included former Republican Governor Raymond Shafer, Republican Congressman Tim Lee Carter, Republican Senator Jacob Javits, Democratic Senator Harold Hughes and doctors and psychiatrists, among others. The Shafer Commission was supposed to validate a Schedule I classification.
In early 1972, Chairman Shafer delivered its findings to Congress in a report titled "Marihuana, A Signal of Misunderstanding" calling for an end to cannabis prohibition. “[The CSA] implies an overwhelming indictment of the behavior which we believe is not appropriate,” said the cannabis report. “The actual and potential harm of use of the drug is not great enough to justify intrusion by the criminal law into private behavior, a step which our society takes only with the greatest reluctance.... Looking only at the effects on the individual, there is little proven danger of physical or psychological harm from the experimental or intermittent use of the natural preparations of cannabis."
The commission attacked the “lurid accounts” of unsubstantiated cannabis-related atrocities and questioned the constitutionality of prohibition in general. "The use of drugs for pleasure or other non-medical purposes is not inherently irresponsible,” noted the commission, in support of recreational use. “Alcohol is widely used as an acceptable part of social activities."
Despite the findings, round three also went to the bureaucrats, but with added venom. Medical research into Schedule I drugs involves many hurdles, but an additional level of oversight—the Public Health Service (PHS) review—was created exclusively for cannabis. This literally made cannabis the most restricted drug in the United States. (President Obama lifted the PHS review in June 2015.)
Moreover, the effort to keep cannabis a Schedule I drug included direct intervention from President Richard Nixon himself. Tricky Dick, who once tried to deport John Lennon for a potentially bogus cannabis possession charge in England, told Schafer, “You're enough of a pro to know that for you to come out with something that would run counter to what the Congress feels and what the country feels, and what we're planning to do, would make your commission just look bad as hell.” Nixon added that individuals standing against cannabis prohibition were “not good people.”
Dr. Aggarwal notes, “I actually wrote an article called “Health Scientist Blacklisting and the Meaning of Marijuana in the Oval Office in the Early 1970s” in which I analyzed the Nixon tapes in annotated depth. It really goes into the psychiatrists and health professionals who were lobbying for and against Schedule I at the time and what Nixon said on the tapes about that. Everyone knows the tapes include racist language, but they also show who he threatened to fire at the National Institutes of Health.”
As noted in the doctor’s article, Dr. Bertram Brown, Director of the National Institute of Mental Health (NIMH), appeared in a front page Washington Post article saying cannabis possession penalties should be “minimal or non-existent… like for a parking ticket.” Per public transcripts from the Oval Office, Nixon said, “Now did you see this statement by Brown, the National Institute of Mental Health this morning? Uh, he should be out. I mean, today, today. If he’s a presidential appointee [unintelligible] do is fire the son of a bitch, and I mean today! Get the son of a bitch out of here… Let Brown get people on the couch and whatever these other people do with him, but goddamn it, keep ‘em out of the drug business… Who comes out and makes a speech on marijuana is the same as a traffic ticket and we should pay no attention to it. The hell with him!”
To this day, medical doctors must fight against bureaucrats who worry about losing votes, power, funding and support, especially from lobbyists for law enforcement, private prisons and pharmaceuticals. The Drug Enforcement Administration (DEA) itself stands to lose considerable funding when cannabis prohibition ends. Sure, some doctors still speak out against cannabis, but they represent the minority.
WebMD and Medscape surveyed nearly 3,000 doctors about medical cannabis. The findings, released in 2014, showed the majority of doctors supported medical cannabis, and nearly 70 percent agreed the plant can help patients with certain conditions. Support jumped to 82 percent among oncologists and hematologists, and 60 percent of doctors who tried cannabis supported full-scale legalization. In fact, support for legal medical cannabis was higher among doctors than it was in a similar survey taken of WebMD readers.
Dr. Michael Smith, the Chief Medical Editor of WebTV, remarked, “The medical community is clearly saying they support using marijuana as a potential treatment option for any number of medical problems. In fact, many doctors already prescribe it.... The findings would indicate a strong desire to have the DEA ease the restrictions on research.”
In terms of educating the public, Dr. Sanjay Gupta provided a watershed moment with a 2014 special report about how cannabis-extracted cannabidiol (CBD) radically helped Charlotte Figi, a young girl who suffered from vicious epileptic seizures. The Emmy-winning neurosurgeon, who followed with additional cannabis reports, reversed course on prohibition and very publically endorsed medical cannabis. In 2015, he even called for a medical cannabis revolution.
Will round four go to the doctors? It might, with so many medical professionals and scholars now unified in the fight against prohibition.
Dr. Warf remarks, “I often conclude my [speaking engagements] by saying, ‘In the U.S., 480,000 people a year die from tobacco. About 200,000 die from alcohol abuse, not including drunk driving. No one, ever, has been killed [directly] by smoking cannabis.’ There's never been a medically confirmed case of anyone ever dying from it, yet we subsidize tobacco and make cannabis a Schedule I drug. It is an act of such ludicrous stupidity that it's just mind-boggling.”
Dr. Aggarwal personally marvels at the bureaucrats’ decision to strip medical cannabis and addiction issues from the medical community and put them in the hands of law enforcement.
“In the 1960s under the [Lyndon] Johnson Administration, Timothy Leary famously went to Congress to testify at a Congressional panel,” he recalls. “Leary marked an important moment in the '60s when drug control was handed to the cops as opposed to the doctors. It was something that Robert F. Kennedy and other voices opposed, but there was too much political capital at stake. Rather than making this a medical and health issue, we really gave it over to people who had no such training. That's how it stands still to this day, under the federal law.”
In particular, the DEA holds an enormous amount of power.
Dr. Aggarwal continues, “Yes, the DEA must be advised by the Department of Health and Human Services [HHS], and some things the HHS says the DEA cannot overrule, but it really doesn’t assert much. They’ve just become so dependent on making nice. It's the political dominance of bureaucratic law enforcement over medical and health-oriented professionals in cannabis law and policy. None of it has been about passionate, health-driven, human rights- and ethics-driven policy in which you focus on the individual patients and the public. It’s not about public health needs.”
Still, Dr. Aggarwal believes the Information Age has helped educate the general public, and the next rounds might go the doctors’ way.
“I think that consensus has shifted quite a bit,” he explains. “It's just a matter of time until people recognize this heavy-handed attitude is going to lose a lot of return. Eventually it will all be abandoned for health-oriented approaches. That's my hope, and that's part of why we have formed Doctors for Cannabis Regulation. We have medical ethics guidelines that we honor regarding advocating for changes to laws that are in the best interest of patients."
Finally, in a firm tone, the doctor concludes, "This is our turf. We need to assert what's right for our patients.”
David Jenison (firstname.lastname@example.org) is Editor-in-Chief at PRØHBTD.