Medical Marijuana in Three Countries: The Advantages of Federalism

Jacob Sullum | June 25, 2009

Last week Ha'aretz ran a story about medical marijuana in Israel (the country where THC was first isolated, back in 1964). It provides some interesting contrasts with the situation in the United States. Unlike here, where 13 states recognize cannabis as a legitimate medicine but the national government continues to forbid all uses of the plant, the decisions in Israel have been made centrally and by regulation, as opposed to ballot initiative or statute. In 1999, three years after California voters approved America's first medical marijuana initiative, the Israeli Health Ministry began allowing patients to use the drug. But there was no legal way for patients to obtain marijuana if they were not up to the task of growing their own. In 2001 one of the first patients with a prescription for marijuana was arrested and tried for buying it from a dealer. Four years ago, the Israeli government finally authorized cultivation of medical marijuana, but until recently it was limited to a single operation. As the number of marijuana prescriptions continued to rise (it's expected to hit 1,200 this fall), it became clear that more suppliers would be needed. This year an entrepreneur with expertise in growng many different varieties of cannabis opened a second legal pot farm, and the Health Ministry plans to license three or four more.

While Israel's policy is more rational than the American policy at the federal level, which elevates anti-drug orthodoxy above science and the interests of patients, it has the quirks you'd expect from a centrally planned system. In the whole country, only one doctor is allowed to prescribe marijuana, forcing patients to wait needlessly. For six years there was no legal supplier at all, and for another four years only one. Controversy continues over whether the national health care system should cover cannabis, whether patients should pay anything out of pocket, and if so how much—all issues that ultimately will be decided for the entire country by Health Ministry bureaucrats.

In California, by contrast, any doctor can recommend cannabis to his patients, and privately run medical marijuana dispensaries have proliferated, based mainly on the legal premise that the people running them are "primary caregivers" for their customers and therefore allowed to provide cannabis to them. Last fall the California Supreme Court rejected that rationale, so it looks like dispensaries from now on will have to follow a patient-run cooperative model (since patients are allowed to grow their own cannabis). Meanwhile, of course, the federal government has periodically raided dispensaries and arrested their operators. But despite the murky legal status of the dispensaries, medical marijuana is more readily available to patients in California than it is in Israel, where it has the national government's blessing. The same should soon be true in New Mexico and Rhode Island, which recently authorized medical marijuana suppliers.

The Ha'aretz story reminded me of an encounter I had during a trip to Toronto last week. A woman at the conference I attended showed me her medical marijuana license, a laminated card that looks like a driver's license and signifies that she has the Canadian government's permission to use cannabis for symptom relief. Although that license reflects a more enlightened approach than our federal government taken, she immediately complained that in Canada there's only one legal source of medical marijuana: the national health bureaucracy. In the U.S., she said, "people have more freedom."

Legislation approved yesterday would make New Hampshire the 14th state to allow medical use of cannabis, with the supply coming from state-licensed "compassion centers." Gov. John Lynch, a Democrat, says he has not decided yet whether to sign the bill.

[Thanks to Bruce Mirken at the Marijuana Policy Project for the Ha'aretz link.] 

Comments

|6.25.09 @ 12:01PM|#

Legislation approved yesterday would make New Hampshire the 14th state to allow medical use of cannabis

I thought NH slogan was "live free or die", now they will need to change it to "Live free and die" because this legislation would send the wrong message to children that drug abuse and addiction are OK.

Freedom is drug free!

A drug free world, we can do it!

|6.25.09 @ 12:06PM|#

except that no one has ever died from marijuana in recorded human history

|6.25.09 @ 12:08PM|#

A drug free world, we can do it!

Other than being drug free, how is life on Mars?

LarryA|6.25.09 @ 12:12PM|#

I nominate this article for the "number of ways government can screw things up per column inch" award.

|6.25.09 @ 12:12PM|#

Hey Juanita, are you a clown? Drug free world? Whats wrong with you? Ok, you tell someone dieing from cancer they cant have pain kemo treatment. Or you take the morphine from the battle field. You should not be allowed to speak. Useing marijuana in a responcible way is a good thing. As far as children go, well, i put alot of time into my children and they choose to make proud by not useing alcohol tobacco or marijuana, its called parenting, you should try it. Wait, you shouldnt try it, if your gonna wait for your government to send messages to your children then its too late.

Zeb|6.25.09 @ 12:24PM|#

Juanita is a clown. A very consistent and reliable one.

Has anyone ever had a good guess as to the real identity of Juanita?

|6.25.09 @ 12:26PM|#

Patrick

Relax.

"Juanita" is a troll. 'Her' posts are deliberately ironic in a nanny-state voice.

They should be read for the humor value.

Mr Cynical|6.25.09 @ 12:29PM|#

Live free and die.....what is wrong with that? We are all going to die, so why not be free while you live?

Tricky Prickears|6.25.09 @ 12:30PM|#

...would send the wrong message to children...

Stop thinking for your children and start thinking for yourself. It's not the government's job to take care of children, or send messages to children. There are many dangerous and addictive drugs listed as Schedule II that doctors prescribe everyday. They are dispensed at your local pharmacy, every day. That's all the government needs to do; change the classification of marijuana from Schedule I to Schedule II.

Brett Stevens|6.25.09 @ 12:40PM|#

Just legalize the seeds.

If people can get their act together to grow their own, that's reasonable.

If they pass it on to others, that should be illegal.

Robert|6.25.09 @ 12:44PM|#

That's all the government needs to do; change the classification of marijuana from Schedule I to Schedule II.

Not so. Because of the provisions of the FFDCA and state pharmacy laws, it would still need approval of licenses for sale as a drug.

Rick|6.25.09 @ 12:44PM|#

Call Gov. Lynch office and support hb648

http://www.governor.nh.gov/


medical marijuana for trrmanily and chronicly sick.

|6.25.09 @ 12:44PM|#

If they pass it on to others, that should be illegal.

Why is that exactly? I can sell a car to anyone. It's far more dangerous than marijuana.

|6.25.09 @ 12:46PM|#

medical marijuana for trrmanily and chronicly sick.

Yes, medical marijuana for terminally and chronically sick people...and regular marijuana for the rest of us!

|6.25.09 @ 12:49PM|#

Live free or die has been a joke for many, many years.

Let's talk about reality...

Massachusetts has decriminalized mj for up to an ounce and Maine has decrim for (I think) up to two ounces.

Getting dope will still be more of a pain-in-the-ass than necessary, but New Hampshire is a small state and most of the people live in the southern part where roads are good and border access is easy.

|6.25.09 @ 12:53PM|#

fuck, dude.

|6.25.09 @ 1:17PM|#

Marijuana is known to cause irrational, erratic, and criminal behavior in people who have never smoked it.

Frank -n- Weiner|6.25.09 @ 1:27PM|#

"except that no one has ever died from marijuana in recorded human history"

Do you honestly beleive there haven't been MJ warehouse accidents resulting in death?

Look out, Dan! Those bales are falling!

Damn. We was too late.

Frank -n- Weiner|6.25.09 @ 1:28PM|#

"Has anyone ever had a good guess as to the real identity of Juanita?"

Epi?

Big Teat|6.25.09 @ 1:29PM|#

"Live free and die.....what is wrong with that? We are all going to die, so why not be free while you live?"

You working yet?

jtuf|6.25.09 @ 2:50PM|#

For those reading the Ha'aretz article, 4 NIS is about 1 US dollar.

|6.25.09 @ 3:54PM|#

Whats up with jews always having great dope?

Tim Meehan|6.25.09 @ 4:07PM|#

"Although that license reflects a more enlightened approach than our federal government taken, she immediately complained that in Canada there's only one legal source of medical marijuana: the national health bureaucracy. In the U.S., she said, "people have more freedom."

That's not really the case. You can get it from the government supply (like the IND program from Old Miss that supplies...is it five people in the US now?) but the quality is absolutely horrible. (Trust me on this.)

You can also grow your own (with an ATP - Authorization to Produce), or you can get a caregiver (a DPL - Designated Production Licence) to grow it for you.

Of course, the police are still hassling legal growers for their own political ends: http://is.gd/1domW

Tim Meehan|6.25.09 @ 4:10PM|#

Ooops, ATP is the possession licence (Authorization to Possess). A Personal Production Licence (PPL) is the licence that lets you grow your own.

Too many acronyms, even us experts get mixed up.

|6.25.09 @ 4:21PM|#

Pot has been illegal a long time and it is going to stay that way, for good reason because it is not good for us. Why don't you all just grow up and OBEY THE LAW.

Freedom is drug free, let freedom ring!

AB390|6.25.09 @ 4:30PM|#

Our current marijuana laws are impossible to enforce. Despite decades of marijuana eradication and despite arresting 800,000 people a year, pot is still easier to buy for most high school kids than beer.

Keeping marijuana illegal does not benefit our children. It benefits special interest groups: drug cartels, the prison industry, police departments, and government bureaucracies.

It is immoral to prevent responsible adults from choosing to use a less harmful substance in place of alcohol. If pot were legalized, alcohol use would decrease along with its associated social costs.

If you want marijuana to be legalized, taxed, and regulated for adults, YOU can make it happen. Tell your legislators to support California Assembly Bill 390. It's easy. Visit yes390.org

the doctor|6.25.09 @ 4:33PM|#

"Pot has been illegal a long time and it is going to stay that way, for good reason because it is not good for us."



With so much pollution, breathing isn't good for us either. I strongly advise you quit that immediately also...

Russell Barth|6.25.09 @ 5:24PM|#

"In the U.S., she said, "people have more freedom."

In many US states, that is true. sick people in california, where it is still a federal offence, people are allowed to grow and store far more pot than here in Cana-d'uh. it is a nightmare trying to procure meds and obey the law at the same time.

I could tell you stories, man....

|6.25.09 @ 8:54PM|#

OMG, its simply the biggest scam of the last 100 years. A few men back in the 30s decided to take a stand on marijuana based on profit ans self intrests. From than day on we have been fed lies and fear tactics to keep a hold over the public. America has forced many a nation to follow their lead on prohibition even when those countries have used the plant for thousands of years. But the fear of losing medical, military and economic support from us has lead to the world prohibition today.

We all need to read the facts for ourselves and look at the issues. Kids sake, well Ill be damed to let my kids grow up thinking alcohol and tobacco are safe and marijuana is bad. I would rather the governement control marijuana like alcohol than to let gangs and cartels have all the profit and control. Right now in America a teenager can get marijuana faster and easyer than any tobacco or alcohol product, how is prohibition working to keep marijuana out of kids hands, its not! It handed our kids over to the gangs and cartels for them to do what they want. Gateway, well if it was not handed over to the same guys who sell harder drugs then they wouldnt even consider other drugs, "hey Im out of pot but I have "this" try it", prohibition causes any gateway that may be there!

On top of any of that, marijuana is Cannabis and Cannabis has been used since the start of time to treat almost every illness, its the worlds most medicaly active plant and it is so safe it hasnt and can not kill anyone! Cant even say that about asprin, I believe 500 died last year in the USA due to asprin, yet you can find asprin in every home in the USA and world!

Its truly sad when the public knows better and the leaders of the world dont care about it. These failed policys world wide have cause more harm than any good that could have happened. In the USA alone, 5% of the worlds population, we imprison 20% of the worlds criminals, so we arrest 1 in 30 americans based on non violent drug use. Its truly a crime when a government arrests such a large percent of its population, is it truly the government that is right when they are arresting so many, 2 million marijuana users in prison, 1 million arrests this eyar alone? Its truly sad and we all are victoms in one way or another in this Drug War!

Dont forget this is a War and there are thousands of deaths due to it, many because of overzelous cops and police that jump at any chance to boost their drug numbers, in trun getting more money to fight said drug crimes! We are all going to suffer if this continues into a new decade. History will look back at the Drug War as a farse, a scam and wrong in so many ways. Which side will you be on when they start looking at whom caused and supported this mess? What War crimes will come about due to para military type raids on citizens and what punishmenets will we give out?

Everyone get off your collective butts and start fighting for freedom and we can stop this stupid game that we call "The War on Drugs"!

palmspringsbum|6.25.09 @ 10:03PM|#

Drug free or die.

Got it, Juanita.

|6.26.09 @ 1:12AM|#

Everyone has the right to freedom. Whether the opion is idiotic or not part of freedom is expression of speech. I do'nt agree with a comment of a person posting. She still has an opinion. As I try to afford 140 oxycodone every two weeks along with Methadone 84 tabs and 90 valium for a pain cocktail. The government is bitching about a wild plant with infinite uses. Let the stupididity trickle like a broken fawcett.

Bryan Epis|6.26.09 @ 2:09AM|#

Juanita is a member of a police force, or prison guard union, or a CEO of a company that sells goods to prisons.

I've created a web page that asks people to sign 8 petitions related to changing unjust marijuana laws, including ending marijuana prohibition, as well as ending raids, dismissing pending prosecutions, and pardoning federal defendants charged with the "crime" of following state medical marijuana law (the Obama administration hasn't made even the slightest "change" here yet). The whole process only takes 8-16 minutes as it only takes 1-2 minutes to sign each petition. Please see http://bestlodging.com/politics (this page isn't linked from my Best Lodging home page as I want to keep the hotel reservation site separate). While you're there you can check out my new diet/muscle gain web site that is really free, which is located at http://bestlodging.com/diet - Thanks, Bryan Epis

|6.26.09 @ 1:00PM|#

How long before they realize they're hurting patients who need this medicine ?? How long before they develop new delivery systems, so we can avoid smoking it ?? How long can we ignore the many studies that indicate it has tumor-inhibiting qualities ?? How long do we stay in the dark ?
Sign the bill, Gov. Lynch.

Pragmatist|6.26.09 @ 2:47PM|#

Pot has been illegal a long time and it is going to stay that way, for good reason because it is not good for us. Why don't you all just grow up and OBEY THE LAW.

You know, not returning runaway slaves to their owners used to be a crime. Jim Crow was not an illusion. I'm sure the minds behind the Nuremberg laws thought they had good intentions.

In America, we have this thing called a the US Constitution which guarantees us certain rights. Perhaps you have heard of constitutional amendments such as the 18th and 21st amendment. We had one experiment with changing our constitution to please teetotalers and the result was Al Capone. Now, instead of actually amending our constitution, our government chose to change our laws in order to coercively bind us to an international treaty prohibiting certain plants. Those of us who want to end this simply desire sovereignty and freedom.

What kind of defense is "we've been running this scam for a long time" anyway? Should Bernie Madoff have considered this as a defense?

|6.27.09 @ 3:14PM|#

excuse my french, But "sign the dam bill, and stop playing games with your fellow compadres"

"free the dam tree" already!

Kris Hermes|6.27.09 @ 3:18PM|#

Thanks for the interesting insights, Jacob! I think it's important to compare the way different countries treat something like medical marijuana.

However, I want to clarify something you said:

"...privately run medical marijuana dispensaries have proliferated, based mainly on the legal premise that the people running them are 'primary caregivers' for their customers and therefore allowed to provide cannabis to them."

In fact, this legal rationale for the existence of dispensaries in California was rejected by the state courts way back in 1997 under the Lungren v. Peron decision. Instead, the legal rationale comes from the Medical Marijuana Program (MMP) Act adopted by the state legislature in 2004, which protects collective and cooperative cultivation. The MMP combined with the relatively unknown court decision in People v. Urziceanu paved the way for collectively and cooperatively operated dispensaries.

Then, in August 2008, the California Attorney General issued guidelines recognizing the legality of storefront dispensaries as long as they operated collectively or cooperatively.

While the November 2008 California Supreme Court ruling to which you refer in People v. Mentch did include reference to the way dispensaries operate, the case was really about one person, Roger Mentch, and reference to dispensing was simply a re-hash of the Lungren v. Peron decision from more than 10 years earlier.

Americans for Safe Access (ASA), which filed an amicus brief in the Mentch case and helped to draft the Attorney General guidelines, has for years been trying to educate patients, dispensary operators and lawyers about the need for dispensaries to operate collectively or cooperatively. Unfortunately, many still think they are protected by organizing as caregivers for hundreds if not thousands of patients. To do so not only violates federal law, but state law as well.