Following overwhelming approval of the medical marijuana ballot initiative in November, Massachusetts’ patients are waiting for safe access to their medicine as the state proceeds with implementation. We aren’t there yet, but so far progress is continuing in the right direction, thanks to the work of patient advocates from around the state. There have been a number of exciting advancements over the last several weeks.

The Attorney General issued a ruling that cities and towns cannot ban medical treatment centers from opening. Despite the overwhelming passage of the initiative that won in 350 out of 351 communities, a small minority of municipalities had attempted to forbid treatment centers from operating within their jurisdictions, largely based on unfounded fears about how treatment centers will work. Supporters within these towns have been frustrated with local officials’ attempting to overturn the will of the voters by passing bans. The AG has decided that these efforts are not legal, based on the reasoning that if one town can ban treatment centers, they all can. If that happened, implementation of the medical marijuana law would be impossible, and therefore these local bans are not permitted under state law. However, the AG also found that cities and towns can pass temporary moratoriums or zoning ordinance to address treatment center siting, as long as they do not ban the centers outright.

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I am honored and delighted to be able to publish here for the first time a new comprehensive piece written by Dr. Lester Grinspoon, Emeritus Professor of Psychiatry at Harvard Medical School, entitled “Cannabinopathic Medicine”. Dr. Grinspoon started writing this piece in 2012, when I was privileged to read an early draft and give editorial suggestions. He has been looking for a suitable venue for publishing it where it could be read widely. I am grateful that he agreed to allow me to use this blog space to share it. It is approximately 6,000 words and well worth a read.

First, a brief introduction. Dr. Grinspoon, who is in his eighties, is a great physician and researcher who has been a co-author, instructive mentor, and guide of mine. He is known for his pioneering work on the social and medicinal uses of cannabis, but before that, he made significant contributions such as introducing the use of lithium in the treatment of bipolar disorder, the starting of the Harvard Mental Health letter, and many other achievements such as senior psychiatrist at the Massachusetts Mental Health Center in Boston for 40 years, fellow of the American Association for the Advancement of Science and the American Psychiatric Association, founding editor of the The American Psychiatric Association Annual Review, and editor of the Harvard Mental Health Letter for fifteen years, to name a few. It is a wonderful turn of events that Dr. Grinspoon’s home state Massachusetts passed a voter initiative by wide margin to legalize the medicinal use of cannabis for patients with conditions that a physician believes may benefit from its use. That law went into effect this year and now, as of this month, Harvard Medical School-affiliated faculty, in collaboration with the Massachusetts Medical Society, are producing and editing AMA-certified continuing medical education online course series on the medicinal uses of cannabis, vindicating Dr. Grinspoon’s remarkable foresight from over 40 years prior.

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According to Matt Taibbi, in his latest Rolling Stone exposé on the banking and financial industry “Too Big to Jail,” HSBC “helped to wash hundreds of millions of dollars for drug mobs, including Mexico’s Sinaloa drug cartel,” and also “moved money for organizations linked to Al Qaeda and Hezbollah, and for Russian gangsters; helped countries like Iran, the Sudan and North Korea evade sanctions.”

Yet, as outrageous as these transgressions are, the Justice Department refuses to criminally prosecute the bankers committing federal crimes right under the nose of the U.S. government.

At a press conference where the Justice Department announced a settlement between the government and HSBC, in which the bank was forced to pay $1.9 billion, but without any individual being fined or prosecuted, Assistant Attorney General Lanny Breuer had this to say:

Had the U.S. authorities decided to press criminal charges, HSBC would almost certainly have lost its banking license in the U.S., the future of the institution would have been under threat and the entire banking system would have been destabilized.

So, the lesson we’re supposed to take from that is this:

if you’re a banker you can commit federal felonies and all you have to endure is a slap on the wrist. However, if you’re in any other line of business and you commit federal felonies, all bets are off.

If you’re a medical marijuana provider, for example, the Justice Department will not just look the other way as it did for years with HSBC. Instead, you can expect the government to come after you with the full force of the law.

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Earlier in the week, we posted a blog from one of our Board Members, Dr. Karen Munkacy, who is working hard on making sure that implementation of Massachusetts’ medical cannabis program goes smoothly.  Of course, Massachusetts scored a huge victory for safe access when they passed their initiative last November, but few people understand that this is only the first step towards ensuring patients get access to legal medicine in a state. The battle we’re fighting now, with the help of advocates like Dr. Munkacy, is making sure that the rules and regulations for the program are composed in a way that most benefits the patients.

The good news is that what has truly been a battle in other states has become a welcome and open dialogue with the MA Department of Public Health (DPH), who is charged with the difficult task of interpreting the initiative while writing the program’s regulations. In fact, DPH is actually looking for public input on a number of issues and are holding Townhall-type meetings called “Listening Sessions” in the next few weeks. This is a great opportunity for MA patients and advocates to submit comments on these seven issues:

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Just hours after the U.S. Court of Appeal for the D.C. Circuit heard oral arguments in the federal landmark case Americans for Safe Access v. Drug Enforcement Administration, the court ordered supplemental briefing on the issue of “standing.” In a rare move for a case that has been covered by the Associated Press, Reuters, CNN, Bloomberg News, Los Angeles Times, San Francisco Chronicle, Huffington Post, and others, the request for additional briefing indicates that the court is taking the issue of medical marijuana very seriously.

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This morning, the federal Appeals Court for the DC Circuit heard an appeal in the case called Americans for Safe Access v Drug Enforcement Administration. The case is an appeal of the DEA’s rejection of a petition filed in 2002 seeking to change the placement of marijuana as a Schedule I drug per the Controlled Substances Act. Based on the scientific evidence, ASA and our fellow plaintiffs feel that it is simply untrue that cannabis is a drug with a “high potential for abuse” and “without accepted medical use in treatment in the United States.” The hearing today offered a glimpse at the Court’s approach to this topic.

In front of a packed courtroom in Washington, the three-judge panel questioned ASA’s Chief Counsel Joe Elford and a federal lawyer about the merits of the scientific case, and the crucial legal issue of “standing.” Standing is a legal concept that restricts the right to sue to injured parties – people who are directly hurt by what they are fighting, and can get relief from a legal judgement. The issue of standing has been the reason why two prior appeals of the DEA’s classification of marijuana were rejected. In the past, patients have not been part of lawsuits against the Controlled Substances Act. The three judges were Merrick Garland, Karen Henderson, and Harry Edwards. (more…)

Shortly after California passed Prop. 215 in 1996, I asked the chief physician at my county clinic for a verbal or written recommendation to use cannabis medicinally. He told me that, while he had no problem with me using cannabis for my conditions, he was afraid to make any kind of recommendation without proper authorization and guidelines. He said as long as cannabis is a Schedule I drug, he could not prescribe it to me.

Over the years living with epilepsy and Post-Polio Syndrome, I have been prescribed and used a myriad of over and under the counter medications for pain, seizures, inflammation, nausea (Marinol), anxiety, insomnia etc. and none of the medications I have taken are as effective, tolerable and free of side-effects (both short term and long term) as cannabis.

After being denied by my doctor, I met with the clinic director who said the same thing as every medical professional and county/state health department representative I communicated with: “As long as cannabis is a schedule I drug, I cannot help you.”
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Today is the 75th anniversary of marijuana prohibition in the U.S. and, as a society, we’re no better off for it. In fact, many would argue that we’re far worse off with prohibition than if at any point we had developed a sensible public health policy with regard to marijuana use.

The effects of marijuana prohibition have been unmistakable from a law enforcement standpoint — the U.S. imprisons more people for marijuana than any other country. However, the effects on society of criminalizing marijuana for therapeutic use are also significant and undeniable.

Before the Marihuana Tax Act (MTA) was passed in 1937, medical marijuana (also known as cannabis) was commonly sold by pharmaceutical companies like Eli Lilly. However, Harry Anslinger, the country’s first drug czar, made sure that no exception was made for such therapeutic uses.

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David Sack in his recent HuffPo post entitled “Marijuana: The New Snake Oil” challenges the status of medical marijuana, an increasingly popular alternative treatment, as “good medicine.” This question is particularly relevant because the Washington DC federal Court of Appeals will soon hear a lawsuit disputing the status of marijuana in Schedule I of the Controlled Substances Act, brought by Americans for Safe Access, a national member-based organizaton advocating for medical cannabis access and research. I am a doctor and a board member of the ASA Foundation, and I’m proud to present a medical professionals’ perspectives to the cause.
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