Despite this week's refusal by the Supreme Court to uphold gag orders against doctors who tell their patients about the benefits of marijuana, AIDS and cancer sufferers still have a long way to go before they can smoke their pot in peace.
"I don't think this is a big victory for medical marijuana," said Vikram Amar, a law professor at the University of California Hastings College of the Law. "Unless the federal government can't criminalize its use or cultivation, big deal. Doctors can recommend it, but no one can act on the recommendation."
To make things more complicated, the Supreme Court's decision isn't permanent, doesn't cover the entire nation and suggests nothing about the court's views on medical marijuana in general.
Eight states allow patients to take marijuana for medical reasons, although it cannot be prescribed. Others provide varying levels of protection to patients and research subjects. But both the Clinton and Bush administrations have worked to keep the drug out of the hands of patients in the first place by muzzling doctors and prosecuting marijuana growers.
In the latest legal twist, the justices on Monday refused to hear an appeal of a 9th Circuit Court of Appeals decision that overturned rules prohibiting doctors from discussing marijuana with their patients.
The decision only affects the Western states covered by the famously liberal 9th Circuit. These include seven of the eight states with the most wide-ranging medical marijuana laws: Alaska, California, Colorado, Hawaii, Nevada, Oregon and Washington. (Maine is the eighth state.)
However, the Supreme Court could still revisit the issue, especially if a more conservative appeals court creates confusion by going the other way.
"We don't know whether it means they think the case was rightly decided or they just don't want to look at it yet because it isn't time," said Edward Richards, professor of law at Louisiana State University.
For now, though, federal agents are prevented from threatening to revoke the drug licenses of doctors who talk to their patients about the benefits of smoking pot to curb pain and nausea.
The gag order was "a fundamental infringement on our right to give medical information to our patients," said Dr. Debu Tripathy, a breast cancer specialist at the University of Texas who used to practice in California. "They decided to go after the physicians because we were easy targets. They control things like reimbursement by Medicare, and our drug-prescribing licenses are held at a federal level."
Tripathy, a plaintiff in the gag-order case, said he doesn't usually mention marijuana to patients because its value hasn't been proven. But the threat of prosecution made him feel uncomfortable when patients merely asked for his opinion.
"If I thought it wasn't a good idea, that they shouldn't do it, I could probably bring that up, but you never know how the federal government would react," he said. "I could have said something, my patient could have misunderstood and gone to a cannabis club and gotten arrested. Then I would be on the line."
The Bush administration does not appear to be backing down from its tough stance on marijuana. The office of the federal drug czar issued a statement saying that the cultivation and trafficking of marijuana remains illegal: "It remains the charge of every responsible public official and medical professional to continue to protect the health of American citizens and reduce the harms caused by marijuana and other dependency-producing drugs."
The federal government still has "arrows in its quiver" in doctors' offices, said law professor Richards. Officials can still try to ban discussions of marijuana use by doctors who accept Medicare or Medicaid funding.
But the big disputes over medical marijuana appear likely to continue revolving around cannabis clubs, which provide marijuana to sick people, and research laboratories, where scientists are working to understand why marijuana seems to do a good job of reducing pain, nausea and muscle spasms in multiple sclerosis patients.
In California, two cases involving marijuana providers are working their way through the 9th Circuit. Also in California, university labs are continuing their investigation of marijuana's use as a medicine.
Despite great advances in treatment, severe pain and nausea continue to plague AIDS and cancer patients, especially in terminal stages of the illnesses. Advocates and critics disagree over whether marijuana offers relief that isn't available from legal drugs.
The goal of the research is to gather enough data to convince doctors and regulators that marijuana is beneficial, said Dr. Donald Abrams, who studies the drug at the University of California at San Francisco.
Meanwhile, pharmaceutical companies are exploring ways to provide the benefits of marijuana without making patients high, although Abrams doesn't see anything wrong with terminally ill people getting stoned "if it's not interfering with their ability to do what they need to do."
http://www.wired.com/news/politics/0,1283,60838-2,00.html
"I don't think this is a big victory for medical marijuana," said Vikram Amar, a law professor at the University of California Hastings College of the Law. "Unless the federal government can't criminalize its use or cultivation, big deal. Doctors can recommend it, but no one can act on the recommendation."
To make things more complicated, the Supreme Court's decision isn't permanent, doesn't cover the entire nation and suggests nothing about the court's views on medical marijuana in general.
Eight states allow patients to take marijuana for medical reasons, although it cannot be prescribed. Others provide varying levels of protection to patients and research subjects. But both the Clinton and Bush administrations have worked to keep the drug out of the hands of patients in the first place by muzzling doctors and prosecuting marijuana growers.
In the latest legal twist, the justices on Monday refused to hear an appeal of a 9th Circuit Court of Appeals decision that overturned rules prohibiting doctors from discussing marijuana with their patients.
The decision only affects the Western states covered by the famously liberal 9th Circuit. These include seven of the eight states with the most wide-ranging medical marijuana laws: Alaska, California, Colorado, Hawaii, Nevada, Oregon and Washington. (Maine is the eighth state.)
However, the Supreme Court could still revisit the issue, especially if a more conservative appeals court creates confusion by going the other way.
"We don't know whether it means they think the case was rightly decided or they just don't want to look at it yet because it isn't time," said Edward Richards, professor of law at Louisiana State University.
For now, though, federal agents are prevented from threatening to revoke the drug licenses of doctors who talk to their patients about the benefits of smoking pot to curb pain and nausea.
The gag order was "a fundamental infringement on our right to give medical information to our patients," said Dr. Debu Tripathy, a breast cancer specialist at the University of Texas who used to practice in California. "They decided to go after the physicians because we were easy targets. They control things like reimbursement by Medicare, and our drug-prescribing licenses are held at a federal level."
Tripathy, a plaintiff in the gag-order case, said he doesn't usually mention marijuana to patients because its value hasn't been proven. But the threat of prosecution made him feel uncomfortable when patients merely asked for his opinion.
"If I thought it wasn't a good idea, that they shouldn't do it, I could probably bring that up, but you never know how the federal government would react," he said. "I could have said something, my patient could have misunderstood and gone to a cannabis club and gotten arrested. Then I would be on the line."
The Bush administration does not appear to be backing down from its tough stance on marijuana. The office of the federal drug czar issued a statement saying that the cultivation and trafficking of marijuana remains illegal: "It remains the charge of every responsible public official and medical professional to continue to protect the health of American citizens and reduce the harms caused by marijuana and other dependency-producing drugs."
The federal government still has "arrows in its quiver" in doctors' offices, said law professor Richards. Officials can still try to ban discussions of marijuana use by doctors who accept Medicare or Medicaid funding.
But the big disputes over medical marijuana appear likely to continue revolving around cannabis clubs, which provide marijuana to sick people, and research laboratories, where scientists are working to understand why marijuana seems to do a good job of reducing pain, nausea and muscle spasms in multiple sclerosis patients.
In California, two cases involving marijuana providers are working their way through the 9th Circuit. Also in California, university labs are continuing their investigation of marijuana's use as a medicine.
Despite great advances in treatment, severe pain and nausea continue to plague AIDS and cancer patients, especially in terminal stages of the illnesses. Advocates and critics disagree over whether marijuana offers relief that isn't available from legal drugs.
The goal of the research is to gather enough data to convince doctors and regulators that marijuana is beneficial, said Dr. Donald Abrams, who studies the drug at the University of California at San Francisco.
Meanwhile, pharmaceutical companies are exploring ways to provide the benefits of marijuana without making patients high, although Abrams doesn't see anything wrong with terminally ill people getting stoned "if it's not interfering with their ability to do what they need to do."
http://www.wired.com/news/politics/0,1283,60838-2,00.html
