More than 40 years ago, psychiatry professor Lester Grinspoon wrote a groundbreaking book on marijuana that the New York Times dubbed at the time “the best dope on pot.” Like many in the medical marijuana community, Grinspoon started out as a skeptic intent on researching marijuana’s harms. But his perspective shifted after a personal experience: He had a son with leukemia who found relief only after he started using marijuana before his chemotherapy treatments. Once he started researching marijuana, Grinspoon found that existing information about marijuana was based on propaganda rather than rigorous scientific study.
“I came to realize that I was the one who was misinformed — that despite my training in science and medicine, I had been brainwashed like just about every other citizen of this country,” Grinspoon said in a 2001 interview. For continuing his research on medical marijuana, Grinspoon was in the intervening decades denied promotions and isolated from his Harvard Medical School colleagues until he took emeritus status, he said.
But this month, he returned to give a talk at Harvard Medical School to find for the first time a warm reception. The 200-seat room exceeded capacity. A crowd of attendees waited on a 30-plus-minute line to talk to Grinspoon after the event. No doubt, he faced an audience divided on the issue. But it’s no longer polarized “to the extent it was when I was doing the work,” he said. “Nobody had any interest in it.”
I came to realize that I was the one who was misinformed — that despite my training in science and medicine, I had been brainwashed like just about every other citizen of this country.
Grinspoon, now 85, has lived the evolution of American War on Drugs rhetoric. Until the very recent past, marijuana was relegated to the fringe of mainstream political and scientific discussion. Floating bills in legislatures that were particularly socially progressive or libertarian was one thing. But in the rest of the country and certainly on the national stage, the issue was met with radio silence, relegated to the third rail of politics and not worth the political capital to take a side.
Over the past year, as all eyes turned to the sudden emergence of state recreational marijuana laws, a quiet revolution happened. Medical marijuana began to emerge as mainstream, reborn as a potentially measured and sympathetic compromise in contrast to the more radical move of legalizing recreational marijuana. And politicians are lining up to get behind it.
“Medicinally I think that folks are beginning to see if there are things which the medical community can help on and has specific ways that they can then I think the legislature might consider that but to move beyond that I would say is a bridge too far but that bridge has not yet been built,” Nixon told CNN’s Candy Crowley.
A month earlier, when Louisiana Gov. Bobby Jindal (R) faced an overflowing room questioning his position on legalization of all possession, he tempered his opposition with never-before-expressed support for another marijuana policy.
“I continue to be opposed to legalization of marijuana,” he said. “When it comes to medical marijuana … if there is a legitimate medical need, I’d certainly be open to making it available under very strict supervision for patients that would benefit from that.”
Even Senate Majority Leader Harry Reid (D-NV) conceded this year on medical marijuana, “If you’d asked me this question a dozen years ago, it would have been easy to answer – I would have said no, because [marijuana] leads to other stuff. But I can’t say that anymore.”
Twenty-one states and the District of Columbia now have medical marijuana laws. Polls have found voter support for medical marijuana as high as 85 percent. And while the law still lags behind public opinion, it’s easy to forget just how recently any support for marijuana was on the outskirts of mainstream public opinion.
When Medical Marijuana Was ‘Medical’
In 1970, Congress first established the Controlled Substances Act in the wake of the Reefer Madness era. Assessing the relative medical benefits of marijuana, the initial House of Representatives report recommended that Congress classify marijuana as a dangerous drug with no currently accepted medical value, at least temporarily “until the completion of certain studies now underway to resolve the issue.” Scientific study that relied heavily on self-reporting both before and after this assessment suggested the medical potential of marijuana. In fact, the first academic paper touting the benefits of medical marijuana was published in 1843. But Congress’s designation of marijuana as Schedule I put it in the most restrictive category under the law, meaning it could not be prescribed for any purpose.
That very same year, the National Organization for the Reform of Marijuana Laws (NORML) was founded. But they were met in 1971 with the emergence of War on Drugs rhetoric via President Richard Nixon, and with it a public relations campaign that permeated American understanding of illicit drugs for the next 40 years.
A presidential commission appointed by Nixon initially recommended no criminal penalties for marijuana, finding that its “relative potential for harm to the vast majority of individual users and its actual impact on society does not justify a social policy designed to seek out and firmly punish those who use it.” But Nixon insisted he wanted a “Goddamn strong statement about marijuana … that just tears the ass out of them,” as revealed in declassified audio recordings of Nixon’s White House conversations.
Even in the midst of this War on Drugs rhetoric, 11 states passed laws to remove criminal penalties for marijuana possession between 1973 and 1977. In fact, decriminalization was even a campaign issue for President Jimmy Carter, before a backlash brought even that issue back into the dark.
The issue of medical marijuana was received differently. Grinspoon, the Harvard Medical School professor, had been up for an early promotion for his research on schizophrenia. But after he wrote his first book, “Marihuana Reconsidered,” he was denied by the promotions committee because of “controversy” over his marijuana research, he was told. Grinspoon took emeritus status without ever having risen above the level of associate professor.
More than 20 years later, California passed the first law to legalize some medical use and distribution in 1996, and a few other states followed suit in 1998. But even these early laws were passed by ballot initiative without requiring the support of lawmakers. And the idea that marijuana could be used for medical purposes continued to see both public and law enforcement resistance, as federal authorities pursued a series of vigorous crackdowns in states where it was legal.
One of the most publicized crackdowns was against the prominent horticulturist Ed Rosenthal for cultivating marijuana in Oakland, Calif., where it was legal. Like many before and since, Rosenthal was convicted in federal court in a 2003 trial during which it was never mentioned that Rosenthal was growing marijuana for medicinal purposes, permitted by state law.
As jurors left the courtroom after Rosenthal’s trial, they first learned from reporters crowded outside the courthouse that they hadn’t been told the full story about Rosenthal, and expressed regret in what became a moment of national sympathy on medical marijuana. One juror told the New York Times, “I’m sorry doesn’t begin to cover it. It’s the most horrible mistake I’ve ever made in my entire life. And I don’t think that I personally will ever recover from this.” Rosenthal was granted a new trial by a federal appeals court citing juror misconduct. But it was the media coverage of the trial that prompted a fundamental shift in the conversation about medical marijuana, said William Dolphin of Americans for Safe Access.
“There was a substantial change in how the media talked about it after that case,” Dolphin said. “Prior to that case, I never saw an article in the mainstream media — if you’ll pardon the phrase — that didn’t put scare quotes around the word medical. And after that trial the scare quotes were gone.”
It was around that time that Americans for Safe Access was formed, an organization aiming to “protect patients and their rights to safe and legal access.” Their acronym, ASA, was a play on the name of Asa Hutchinson, then the head of the Drug Enforcement Administration, who led aggressive raids in California against individuals like Rosenthal. And the organization was born as an emergency response to these raids.
Hawaii had been the first state whose legislature passed a medical marijuana law in 2000. But in the years after the 2003 Rosenthal trial, other legislatures on the mainland followed suit, including Vermont in 2004 and Rhode Island in 2006 after lawmakers overrode the governor’s veto. In 2009, the American Medical Association even endorsed reviewing the Controlled Substances Act’s designation of marijuana in Schedule I “with the goal of facilitating the conduct of clinical research and development of cannabinoid-based medicines, and alternate delivery methods.”
But in many parts of America, and certainly on the national stage, marijuana remained a third-rail, taboo issue. As late as 2011, even the federal Drug Enforcement Administration was still referring to medical marijuana as “medical” in scare quotes.“The proposition that smoked marijuana is ‘medicine’ is, in sum, false–trickery used by those promoting wholesale legalization,” stated a 2011 DEA memo that asserted marijuana is still “properly categorized under Schedule I.” The memo concluded that FDA-approved drugs are safer for every medical condition than smoking marijuana, and cited a bizarre story in which a 14-year-old girl who was “force-fed” marijuana leaves to help alleviate an adverse reaction to Ecstasy died several days later. There are no known cases of death from a marijuana overdose.
Tom Angell, now chairman of Marijuana Majority, spent much of the mid-2000s lobbying federal lawmakers on drug policy before he decided he had to “bridge the gap between existing public support for many reforms and lack of support by elected officials” first. He said even on issues as subtle as increasing access to education for those with a drug offense on their records, “I would constantly meet with folks and their staffers who would say, ‘look I completely agree with you, but I cannot do anything to help you out in public because this is a third rail issue.’”
“And that sort of constantly running into that line of thinking over the course of my career just made me realize that that’s the major roadblock standing in the way,” Angell said.
A New Era
It is in this moment of increased interest in marijuana policy generally that public support for medical use in particular has skyrocketed. While national support for recreational marijuana nationally exceeded 50 percent after the passage of ballot initiatives in Colorado and Washington, polling for medical marijuana has hit the high 80s in some polls, and majority support holds even in deep red states. The New England Journal of Medicine found that 76 percent of doctors would prescribe marijuana to their patients.
There’s a lot of stuff on the table now that would’ve been unthinkable two years ago.
In a high-profile about-face, CNN Chief Medical Correspondent Sanjay Gupta reversed his position on medical marijuana in August, saying, “we have been terribly and systematically misled” on marijuana. He aired a documentary on a young girl’s success using marijuana to treat seizures that has since prompted more than 100 other families to move to Colorado and seek similar treatment.
The list of politicians first taking a position on marijuana is growing. A Florida ballot initiative on medical marijuana has forced several Democrats to take a position for the first time on the issue, including Sen. Bill Nelson (D-FL) who went from saying marijuana is harmful to saying,“Marijuana used as a medical relief for people that are desperate, I agree that ought to be legal,” and Gubernatorial candidate Charlie Crist (D), who previously opposed decriminalization but came out in favor of medical use in January.
Even the most prominent organization opposing recreational marijuana proposals, Smart Approaches to Marijuana, explicitly endorses greater research on medical marijuana for “cannabis-based medicines.” (although it opposes smoked marijuana and moving the drug from Schedule I.)
And so medical marijuana has emerged as the moderate stance for politicians who feel pressured for the first time to take a position. The Obama administration has taken a number of positions. The Department of Justice recently pledged once againto avert prosecution of those individuals complying with state marijuana law. President Obama conceded that alcohol is more dangerous than marijuana, but the administration has declined to take independent action to reschedule the drug under the Controlled Substances Act. And after years of withholding a legal supply of marijuana for clinical research, a federal panel last month made a potentially momentous shift in allowing access to marijuana for a double-blind study on marijuana and post-traumatic stress disorder.