Sam Uretsky

Against the Law

Years ago, there was a series of public service advertisements warning people about the dangers of marijuana. The disembodied voice, a firm baritone that aspired to be The Voice of Authority and actually came fairly close, concluded, "It's against the law!" End of discussion.

What was missing from the discussion, as it is from many other discussions lately, was: Why is smoking marijuana against the law? The best reason given at the time is that marijuana was a gateway drug. People who smoked marijuana would graduate to other, more harmful drugs. But the reason marijuana was a gateway drug was: Because it was against the law. People using it were in contact with providers of illicit drugs, who hoped to have their customers move up in class, much as General Motors hopes that anyone buying a Chevrolet Aveo will, in the fullness of time, wind up driving a Cadillac V series.

The unstated principle of democracy is that laws should make sense. For example, "Thou shalt not steal" seems clear enough, but "You shall not covet your neighbor's house; you shall not covet your neighbor's wife or his male servant or his ox or his donkey or anything that belongs to your neighbor" takes a bit of explaining. Maybe covetousness is considered a gateway emotion to theft, but it's also the foundation of capitalism.

Logically, the various groups that favor posting the 10 Commandments in schools and court rooms are acting as a combination in restraint of trade. In a theocracy, there is no discussion; a commandment is a commandment. In a democracy, the 10th Commandment should be subject to open debate. (Try this logic: A child's letter to Santa is evidence of wanting something -- coveting. Anyone who covets is naughty. Therefore, any child who asks Santa for presents doesn't get anything.)

And so it was that on April 20, 2006, the United States Food and Drug Administration issued an "Inter-Agency Advisory Regarding Claims That Smoked Marijuana Is a Medicine." The FDA asserts that based on past reviews, marijuana has no medical value, and cites past reviews to confirm its opinion. Meanwhile, 11 states have made some provision for the use of marijuana for medical purposes, and a 1999 review by the National Institute of Medicine, part of the National Academy of Sciences, found marijuana to be "moderately well-suited" to some conditions, including wasting disease from AIDS and the nausea that often results from cancer treatment.

A 2005 report in the journal Neurology described the results of experience with marijuana in the Netherlands. The study abstract said: "The authors investigated the indications for cannabis prescription in the Netherlands and assessed its efficacy and side effects. A majority (64.1%) of patients reported a good or excellent effect on their symptoms. Of these patients, approximately 44% used cannabis for [five months or more]. Indications were neurologic disorders, pain, musculoskeletal disorders and cancer anorexia/cachexia. Inhaled cannabis was perceived as more effective than oral administration. Reported side effects were generally mild."

The issue really isn't about marijuana, it's about the nature of regulation under the current administration. Marinol, the drug name for tetrahydrocannabinol, the active principle in marijuana, is an FDA-approved drug, available from several generic manufacturers for control of the nausea and vomiting associated with cancer treatment, and to prevent the wasting associated with cancer and AIDS.

There is a responsible discussion in the medical literature regarding the possible advantages of cannabis rather than the cannabinoids for medical uses -- but the FDA prefers to take the "because I'm the parent" attitude. While it has been established that drug regulation is subject to federal rules because of the likelihood that drugs will enter into interstate trade, issuing this edict without even bothering to reconsider the evidence favoring medical use of marijuana is consistent with the policies of a government that is more concerned with holding together a shaky political coalition than providing the services expected of government.

In recent years, the FDA has become less a scientific regulatory agency than an agency responsible for maintaining corporate goodwill and a political agenda. Public Citizen's Health Research Group has repeatedly faulted the agency for out-sourcing its responsibilities, including manufacturing plant inspections and providing drug information to the public. Meanwhile, seven drugs approved for marketing since 1996 have had to be withdrawn from the market because they proved to be unsafe -- and some of the drugs currently being marketed are subject to legitimate questions.

A 2003 survey by the US Department of Health and Human Services' Inspector General found that 40% of the FDA's drug reviewers felt that the quality of new drug reviews had been in steady decline, and that there was pressure, not to protect the public, but to give approvals to the pharmaceutical manufacturers. But, the agency that has pushed through approval of drugs that have potentially hazardous effects, several of which ultimately had to be withdrawn, has been sitting on its hands over Plan B, the morning-after pill that could prevent many unwanted pregnancies.

It's not about marijuana, or Plan B, or even stem cells -- it's about an agency that's responsible for scientific studies, health and safety doing what the political base (or a portion thereof) wants, without reviewing the scientific literature. Alan Coren once wrote: "Democracy consists of choosing your dictators after they've told you what you think it is you want to hear." With the possible exceptions of Tom DeLay and Karl Rove, nobody could have said it better.

Sam Uretsky is a writer and pharmacist living on Long Island, N.Y.

From The Progressive Populist, June 1, 2006

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