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October 17, 2011

California's largest association of doctors urges legalization of marijuana

As detailed in this Los Angeles Times article, California's "largest doctor group is calling for legalization of marijuana, even as it pronounces cannabis to be of questionable medical value."  Here is more:

Trustees of the California Medical Assn., which represents more than 35,000 physicians statewide, adopted the position at their annual meeting in Anaheim late Friday. It is the first major medical association in the nation to urge legalization of the drug, according to a group spokeswoman, who said the larger membership was notified Saturday.

Dr. Donald Lyman, the Sacramento physician who wrote the group's new policy, attributed the shift to growing frustration over California's medical marijuana law, which permits cannabis use with a doctor's recommendation. That, he said, has created an untenable situation for physicians: deciding whether to give patients a substance that is illegal under federal law.

"It's an uncomfortable position for doctors," he said. "It is an open question whether cannabis is useful or not. That question can only be answered once it is legalized and more research is done. Then, and only then, can we know what it is useful for."

The CMA's new stance appears to have as much to do with politics as science. The group has rejected one of the main arguments of medical marijuana advocates, declaring that the substance has few proven health benefits and comparing it to a "folk remedy."

The group acknowledges some health risk associated with marijuana use and proposes that it be regulated along the lines of alcohol and tobacco. But it says the consequences of criminalization outweigh the hazards. Lyman says current laws have "proven to be a failed public health policy." He cited increased prison costs, the effect on families when marijuana users are imprisoned and racial inequalities in drug-sentencing cases.

The organization's announcement provoked some angry response. "I wonder what they're smoking," said John Lovell, spokesman for the California Police Chiefs Assn. "Given everything that we know about the physiological impacts of marijuana — how it affects young brains, the number of accidents associated with driving under the influence — it's just an unbelievably irresponsible position."

The CMA's view is also controversial in the medical community. Dr. Robert DuPont, an M.D. and professor of psychiatry at Georgetown Medical School, said the association's call for legalization showed "a reckless disregard of the public health. I think it's going to lead to more use, and that, to me, is a public health concern. I'm not sure they've thought through what the implications of legalization would be."

Dr. Igor Grant, head of the Center for Medicinal Cannabis at UC San Diego, defended the drug's therapeutic use. "There's good evidence that it has medicinal value," he said. "Can you say it's 100% bulletproof? No. But the research we've done at the center shows it's helpful with certain types of pain."

The federal government views cannabis as a substance with no medical use, on a par with heroin and LSD. The CMA wants the Obama administration to reclassify it to help promote further research on its medical potential.

But Washington appears to be moving in the other direction. As recently as July, the federal government turned down a request to reclassify marijuana. That decision is being appealed in federal court by legalization advocates. In recent weeks, the Obama administration has begun cracking down on California's medical marijuana industry, threatening to prosecute landlords who rent buildings to pot dispensaries....

Opinion polls show that state voters continue to be in favor of medical marijuana but are divided on the question of total legalization.  A recent survey by the Public Policy Institute of California found 51% opposed to complete legalization and 46% in favor.

If the CMA and other groups of doctors start becoming vocal advocates for ending pot prohibition, I think there is a pretty good chance public opinion may start tilting even more toward support for legalization efforts.  Doctors are well positioned to bring more light and less heat to the discussion of these issues, especially if they emphasize the potential value of additional research on possible benefits from medical use of marijuana and also discuss more broadly the view that marijuana should be viewed principally as a public health concern rather than as a criminal justice concern.

I also wonder if the CMA or any others have explored the potential connections between pot use and abuse and prescription pain killer use and abuse.  I keep seeing stories about the huge uptick in overdose deaths from oxycodone misuse and the problems created by "pill mills" selling prescription drugs.  When I see these stories, I keep wondering if allowing more people to have more access to relatively mild drugs might actually help reduce the harms of prescription drug abuse.

October 17, 2011 at 08:58 AM | Permalink

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"Lyman says current laws have 'proven to be a failed public health policy.' He cited increased prison costs, the effect on families when marijuana users are imprisoned and racial inequalities in drug-sentencing cases."

The good doctor should stick to his area of expertise. In California, it is impossible to go to jail or prison for smoking or possessing marijuana. Additionally, the Feds also are not prosecuting users for the misdemeanor absent some other federal interest, and those prosecutions are so rare I did not see a single one in my time in the USAO. Selling it is a different matter.

Perhaps the good doctor could tell us what state sends users to prison for smoking a joint. Regardless, it is not happening in the California Medical Association's backyard.

Posted by: David | Oct 17, 2011 10:16:58 AM

The headline says one thing, but you only have to read the first paragraph to see something quite different. The headline says that the CMA has called for legalization. But the first paragraph says that the TRUSTEES of the CMA have adopted that position, and that "the larger membership was notified Saturday."

In other words, the membership has NOT adopted this position. it remains to be seen if they do.

This reminds me of the Prop 19 headlines, which early on were saying that the public favored the measure. When the public actually had its say on election day, Prop 19 lost by 53.5 to 46.5.

Also of note is the story's soft-peddled admission that no other state affiliate of the AMA has endorsed legalization (if it even turns out that the membership of this one does).

Posted by: Bill Otis | Oct 17, 2011 10:33:05 AM

The odd thing about this report is that the doctors contradict the legalization movement on the one factor that is within their expertise: "The group has rejected one of the main arguments of medical marijuana advocates, declaring that the substance has few proven health benefits and comparing it to a 'folk remedy.'"

The principal arguments that CMA accepted may or may not be valid. (My organization takes no position on the question.) But CMA's announcement adds little to the debate.

Posted by: Kent Scheidegger | Oct 17, 2011 1:25:15 PM

Last year there were some 800,000 arrests in the United States for marijuana possession. So apparently someone is going to jail for it.

I think that these doctors are simply recognizing the obvious reality that anyone who's paying attention would have to recognize: the war on drugs, particularly marijuana, has been far more harmful to society, to families, to communities, and to individuals than legalizing it could ever be.

Posted by: C.E. | Oct 17, 2011 11:01:36 PM

C.E. --

"Last year there were some 800,000 arrests in the United States for marijuana possession. So apparently someone is going to jail for it."

By all means tell us how many people are in jail for simple possession of user-only amounts of marijuana. Is it anything close to the 800,000 figure you throw out to catch attention?

No, it isn't. So please provide the actual number.

"I think that these doctors are simply recognizing the obvious reality that anyone who's paying attention would have to recognize: the war on drugs, particularly marijuana, has been far more harmful to society, to families, to communities, and to individuals than legalizing it could ever be."

As I pointed out, and you don't dispute, it's not "these doctors." The membership has not voted on the Trustee's statement.

Still, even if it's adpoted, how is it that the doctors in the other 49 states can't "recognize the obvious reality" that legalizing drugs (do you meab meth and heroin too?) would be a positive development.

Posted by: Bill Otis | Oct 18, 2011 9:05:27 AM

Anyone who believes that the war on drugs has been far more harmful to society, to families, to communities, and to individuals than legalizing it could ever be has never grown up in a household where mommy is higher than a kite and as a result, the children lack adequate care, attention, food and clothing. [Yes, that's right, children need more than just food and clothing.]
Everyone fails to recognize that legalization will result in companies being able to advertise the use of marijuana. We all know that beer makes you fat, but that doesn't prevent those companies from showing fit people drinking it and having a great time. It is somewhat unbelievable to me that we could want to squash tobacco use but legalize marijuana. Really?
What little, if any, value marijuana has, its detrimental effect on children and American families will be shocking. Just because alcohol is legal doesn't mean that it doesn't do a great deal of harm. But alcohol, introduced into Western cultures at the dawn of their cultures, has a different relationship to Western culture than marijuana. Marijuana can, therefore, be treated differently and still make sense. I don't hear anyone claiming to legalize alcohol on Indian reservations. There is a reason to treat different substances differently based on cultural and historical relationships. Give your agenda a rest and for a second, think about the children - when the parents are high, the children will suffer and all your intellectual posturing will not change that. If you so want to smoke pot that badly, take a trip to Amsterdam. Drug enforcement is a heavy toll for our society to pay, but a toll I am willing to pay. I think we can agree that drug treatment is preferable to incarceration without having to legalize marijuana. That solution still focuses on eliminating a known social malady.
I am glad there are still voices willing to stand up for those helpless victims of adult irresponsibility. Aiding and abetting that irresponsibility puts you on the wrong side of protecting the most vulnerable members of our society, and our future. Just because we know someone who can "handle their pot" doesn't mean that the whole culture will be as successful. That's too big of a risk for me to accept.
And there are other differences between alcohol and marijuana. After all, just because alcohol is legal does not mean that drinking to intoxication is suggested. Drinking to intoxication is called alcohol abuse. One can have a little bit of alcohol and not get intoxicated and this is not considered abuse. But there is not really a way of using marijuana in a similar fashion. It is only used in an abusive fashion. Some will argue that they smoke and do not get high, but tolerance to either substance does not mean that someone is less intoxicated, just that they do not feel the same effects (that they don't think they are intoxicated). Self-reporting of intoxication levels is obviously fraught with problems of perception.
For these reasons, I respectfully dissent from the legalization of marijuana. Duping the masses into ignoring these realities does not change the realities.
Mosquitos are natural too, but that doesn't mean we should stop spraying to suppress them, though it is only accomplished at a cost to society.

Posted by: Mark | Oct 18, 2011 9:35:08 AM

Bill Otis: "By all means tell us how many people are in jail for simple possession of user-only amounts of marijuana. Is it anything close to the 800,000 figure you throw out to catch attention? No, it isn't. So please provide the actual number."

I love it when Bill Otis talks out his ass - its no wonder his breath smells like shit.

The Federal Bureau of Investigation’s 2009 Uniform Crime Report showed that there were 858,408 marijuana violations. Approximately 88 percent (758,59) were charged with possession ONLY. The remainder were charged with cultivation offenses.

Open your big mouth and insert foot.

Posted by: Huh? | Oct 18, 2011 11:07:26 PM

Sorry... the 88% should have been 758,593 - I left off the 3.

Posted by: Huh? | Oct 18, 2011 11:09:51 PM

Mark: "Anyone who believes that the war on drugs has been far more harmful to society, to families, to communities, and to individuals than legalizing it could ever be has never grown up in a household where mommy is higher than a kite and as a result, the children lack adequate care, attention, food and clothing. [Yes, that's right, children need more than just food and clothing.]"

The article is about marijuana... not crack, meth or heroine. There is not now, nor has there been any proof that marijuana has had the effect you describe in your uneducated scenario. But, if you have that proof in the form of some hard stats, by all means, post the link.

Posted by: Huh? | Oct 18, 2011 11:16:20 PM

I noticed in a Feb. 14 article about marijuana that Bill Otis mentioned meth, heroin and LSD ["What part of science, compassion, common sense and fiscal prudence suggests that we make meth, heroin or LSD more easily available?"]. Here again he mentions meth and heroin.

Its apparent that you know absolutely nothing about marijuana, or the war on drugs in general. Why is it that you consistently lump other illicit and harmful drugs in with marijuana legalization, Bill Otis?

You once said in another post that "Most people don't care about it. They don't smoke it and have nothing to do with it." Really? The 758,593 Americans arrested for possession of marijuana, in 2009 alone, is no indication of the wide-spread use of marijuana?

Did you know that the US Supreme Court ruled [in 2001] that state and federal laws do not need to conform with each other?

18 states have active medical marijuana programs [Alaska, Arizona, California, Colorado, Delaware, District of Columbia, Hawaii, Maine, Maryland, Michigan, Montana, Nevada, New Jersey, New Mexico, Oregon, Rhode Island, Vermont and Washington], with pending legislation in another 6 [Illinois, Massachusetts, New Hampshire, New York, Ohio and Pennsylvania], not including [almost 11] states that have bills that will carry over to the 2012 legislative session [bills that did not advance out of committee by a certain 2011 deadline], and you keep suggesting that somehow the Supremacy Clause will prevail in preventing the legalization of marijuana.

Posted by: Huh? | Oct 19, 2011 12:22:19 AM

The Federal Bureau of Investigation’s 2010 Uniform Crime Report showed that there were 853,838 marijuana violations. Approximately 88 percent (750,591) were charged with possession ONLY. The remainder were charged with cultivation offenses.

Posted by: Huh? | Oct 19, 2011 12:39:47 AM

Huh? --

It doesn't take a whole lot to understand the difference between (1) being arrested and (2) being sentenced to jail, but it's apparently beyond you.

Did someone here just say, "Open your big mouth and insert foot"?

Posted by: Bill Otis | Oct 19, 2011 11:33:31 AM

The over 800,000 arrests for marijuana is just a start whether or not they are incarcerted. In California the fall out is monumental. The forfeiture threat for landlords, the charging of medical personnel, the potential charging of state employees who regulate and tax the product is something they are thinking of. Because medical marijuana is so imbedded in California culture, federal prosecution could exact a tremendous toll on individual and state resources.

Posted by: beth | Oct 19, 2011 3:26:27 PM

Bill Otis: "It doesn't take a whole lot to understand the difference between (1) being arrested and (2) being sentenced to jail, but it's apparently beyond you."

I suppose you read the Federal Bureau of Investigation’s Uniform Crime Report[s] and found that the 750,591 charged in 2010 and the 758,593 in 2009, over 1.5 million, were NOT incarcerated?? Wait, let me guess... you were the arresting officer.

Pull your head out of your ass Bill. As usual, you are on the wrong side of the issue.

Posted by: Huh? | Oct 19, 2011 3:35:44 PM

Huh? --

"I suppose you read the Federal Bureau of Investigation’s Uniform Crime Report[s] and found that the 750,591 charged in 2010 and the 758,593 in 2009, over 1.5 million, were NOT incarcerated??"

Do you really not understand the English language? I asked a plain question, that being -- once again -- how many people of those arrested for simple possession of marijuana are sentenced to prison? I suppose that, if you're dense enough, you wouldn't understand that that question asks about SENTENCES.

The reason you keep dodging and talking instead only about arrests is that you know full well that only a miniscule number of the arrestees are sent to prison. Do you think you could step up to the plate and admit it?

Posted by: Bill Otis | Oct 19, 2011 4:00:07 PM

beth --

"The over 800,000 arrests for marijuana is just a start whether or not they are incarcerted."

But whether or not they are incarcerated is a perfectly legitimate and relevant question, not so?

Posted by: Bill Otis | Oct 19, 2011 4:03:57 PM

Bill, Yes,of course it is. Mine was just a comment about why the fall out from marijuana arrests and prosecutoins has given imputus to the dialogue and also makes others reflect on the fall out and how it could change their lives. Even just an arrest can have adverse consequences for many more than the arrestee.

My comment was also pretty specific to California, not the 800,000 nation wide. The first sentence probably didn't belong in the comment.

Posted by: beth | Oct 19, 2011 4:49:33 PM

Bill Otis: "Do you really not understand the English language? I asked a plain question, that being -- once again -- how many people of those arrested for simple possession of marijuana are sentenced to prison? I suppose that, if you're dense enough, you wouldn't understand that that question asks about SENTENCES."

You are an asshole, Otis! You did not ask how many were SENTENCED. You asked "HOW MANY PEOPLE ARE IN JAIL." Not every person sitting in a cell this very second was SENTENDED. At any rate, it was you who assumed that the total given was for arrests ONLY. If you weren't such a fat lazy fuck... you'd take the time to find that answer for yourself. Instead, you assume - i.e make an ASS out of yoU not ME.... ass crack.

Posted by: Huh? | Oct 20, 2011 9:49:48 PM

@ Beth

The number of people arrested for possession is relevant. Whether or not the person arrested spends a few hours in a cell waiting to be bailed out, is one of the 13% that spends less than two years in state prison on a marijuana possession charge, or is cited and later appears in court is not as relevant. The swelling California prisons is an example of the extremism that Bill Otis is a proponent of. I think people like Bill just don't want to read the writing on the wall. The growing number of police officers, judges, politicians and Americans in general show that more people are getting ahead of the curve. I guess the real question should be, which side of the issue do you want to be on?

Posted by: Huh? | Oct 20, 2011 10:54:59 PM

I won't defend Huh?'s unnecessarily personal and off-color comments, but I will note that it is actually a lot, lot harder to get sentencing data than arrest data. That is why a lot of people rely on the UCR arrest data for various purposes, with the understanding that the data presumably has a limited, though not completely unhelpful, correlation with prosecutions, convictions, sentences, etc.

Posted by: Anon | Oct 21, 2011 3:45:38 PM

Anon: "I won't defend Huh?'s unnecessarily personal and off-color comments"

Colorful, off-color. Bill changed the question, and then attempted to turn it around on me. Its not as if he hasn't done the same thing to nearly everyone here. He can't handle the truth, or the fact that he was challenged. Sucks to be Bill.

Posted by: Huh? | Oct 21, 2011 9:29:49 PM

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