When California and Arizona voters gave substantial majorities to the proposition that sick people ought to be allowed to use marijuana (and, in Arizona, other illegal drugs) if it might ease their suffering, the reaction in Washington was predictable: utter horror. Propositions 215 and 200 struck not only at the heart of drug war propaganda but also at the most sensitive assumptions underlying the regulatory state. (See "Prescription: Drugs," February 1996.)
For drug warriors, Propositions 215 and 200 are terrifying because these laws recognize that marijuana is not especially dangerous. "We have a problem," said Health and Human Services Secretary Donna Shalala at the Clinton administration's anti-initiative press conference. "Increasing numbers of Americans believe that marijuana is not harmful." Indeed.
Like the once-common insistence that steroids do not help athletes bulk up, the oft-repeated lie that marijuana is some kind of deadly poison leads people–especially young people–to suspect all suggestions that drugs may be dangerous. It's hardly surprising that drug use has turned up among the most propagandized generation in history, or that almost all the upswing is accounted for by casual pot smoking. You don't have to smoke marijuana yourself, or even have a very wide circle of friends, to find plenty of anecdotal evidence that the drug is neither particularly hazardous to health nor the gateway to drug-abuse hell. If she doubts this commonsensical observation, Shalala could ask the president or vice president, among numerous other administration officials with marijuana smoking in their past. Or she could consult mountains of scientific research, much of it aimed at proving the dangers of dope.
As Lester Grinspoon and James B. Bakalar wrote in a 1995 editorial in The Journal of the American Medical Association: "One of marihuana's greatest advantages as a medicine is its remarkable safety. It has little effect on major physiological functions. There is no known case of a lethal overdose; on the basis of animal models, the ratio of lethal to effective dose is estimated as 40,000 to 1….It is true that we do not have studies controlled according to the standards required by the FDA–chiefly because legal, bureaucratic, and financial obstacles are constantly put in the way. The situation is ironical, since so much research has been done on marihuana, often in unsuccessful attempts to prove its dangerous and addictive character, that we know more about it than about most prescription drugs." (This and related articles are available at The Lindesmith Organization.)
Just as anti-gay conservatives are far more threatened by stable, bourgeois same-sex couples (who want to get married!) than by anonymous bathhouse sex or exhibitionists parading in leather jock straps, nothing would undermine the official line on drugs more than lots of respectable, otherwise law-abiding people admitting that they smoke marijuana without ruining their lives. Very few responsible recreational users, however, are likely to risk the legal consequences of coming out of the closet.
The medical marijuana initiatives bypass that problem. They introduce a prospect even more threatening to the status quo: What kind of mean-spirited person, after all, would deny sick people relief? As Jim Christie reported in REASON, even Pat Buchanan sympathizes with patients who need pot, as did Newt Gingrich back in 1981. (See "Club Medicine," April 1996.) Yet if thousands–or even hundreds–of average Americans suddenly start admitting in public that they smoke marijuana to relieve various illnesses, the demonization of the drug can't be sustained.
The Clinton administration is trying mightily not to appear to be attacking physicians. When asked about what they planned to do to deter doctors from recommending marijuana, Shalala and her law-enforcement colleagues–Attorney General Janet Reno and drug czar Barry McCaffrey–dodged desperately. "This isn't about physicians," said Shalala. "This is about truck drivers. It's about workers in federal buildings. It's about teachers." In other words, it's about doctors and their patients.
And the administration is quite assuredly threatening doctors. "We are going to take very, very serious action against them," Drug Enforcement Administration head Thomas Constantine told The New York Times. Reno, meanwhile, urges local authorities to "make arrests and prosecute." Remember, too, that what's at stake is merely recommending marijuana–free speech, in other words, between physicians and patients. The administration that began its first term by repealing the so-called gag rule prohibiting federally funded clinics from advising patients about abortions is starting its second by trying to impose a gag rule in cases where federal money isn't even involved.
In their attempts to manipulate the public by misusing the language, administration officials have decided to wrap themselves in science. Instead of defending the criminal law–which, for the most part, doesn't even fall under their jurisdiction–they are relying on pharmaceutical regulation to save them.
"We have a consensus in this country and national law that establishes a standard for drugs that are used in California and in New York. The NIH and the FDA are the core of that approval process," said Shalala at the December 30 press conference. "If it starts falling apart and every state legislature can suddenly approve a drug–not based on any scientific fact–we are undermining the basic health and scientific standard by which this country has established the most extraordinary quality of health care….What's at stake are our youngsters, but just as important, the scientific base for our entire health care system."
This statement was designed to confuse both the journalists in the room and the public at large. For starters, the National Institutes of Health ordinarily have no role in approving drugs. They fund biomedical research, some of which leads to new pharmaceuticals. Most new drugs come not from the government but from private companies, entities that apparently don't exist in Shalala's mental universe. Nor is it clear that U.S. pharmaceutical innovation–much less the "entire health care system," which includes unregulated and highly innovative and successful medical procedures–depends on the FDA.
Second, not all biologically active substances fall under Shalala's precious approval process. Some "medicines" are not pharmaceuticals but folk wisdom, often eventually backed by experimental science. If I tell you to put ice or cold water on a burn or eat chicken soup and drink hot tea for a cold, I do not need FDA approval. More analogous–given the product's ordinary use–is the old, and in my experience highly effective, Southern folk remedy of putting a paste of tobacco on bee stings. Suggesting that a plant might relieve your symptoms is not the same as prescribing a commercial pharmaceutical. If marijuana had never been made illegal, using it medically as well as recreationally might require no more FDA approval than drinking herbal tea. And since marijuana isn't patentable, no pharmaceutical company would invest in FDA testing, even if it were legal.
Since it isn't legal, Shalala's "approval process" is not just the FDA's normal hoops–as bad as they are. (See "The Other Drug War," November 1996.) While there is little doubt that smoking marijuana can relieve glaucoma, chemotherapy-induced nausea, and AIDS-related wasting, it would indeed be nice to have more solid scientific research on the subject. But it's essentially impossible to do efficacy testing on a substance whose very possession is a crime.
That's where the NIH comes in. You can't just, as a scientific matter, decide to investigate whether marijuana might relieve nausea or migraines. If you want to do your research legally, the DEA and National Institute on Drug Abuse will have to approve–and recent history suggests they won't. (Plus, researching the possible medicinal benefits of evil, illicit, politically incorrect substances is not exactly the way to win friends, grants, or tenure.) As a result, there are no ongoing studies. That Shalala, McCaffrey, and Janet Reno spent a press conference pretending otherwise just shows the Clinton administration's endless ability to twist the facts to suit its political spin.
The Arizona and California propositions don't just subvert the drug war by threatening to expose its propaganda. They attack the favorite argument for big, technocratic government: "health and safety." They dare to suggest that health is, for the most part, an individual, private matter; that safety depends on how each person weighs relative dangers; and that knowledge about both is not the sole possession of centralized bureaucrats. The initiatives explode the most beloved premises of paternalistic Progressivism. No wonder the Clintonistas are going crazy. This isn't a battle they can afford to lose.