Gallup Polls Support and Opposition to Marijuana Legalization 1969-2011

As 50% of Americans now support marijuana legalization, the prohibitionists are coming out in full force with hysterical propaganda to once again terrorize voters about cannabis.  We intended to scour multiple sources to compile the five most common scare tactics they use, but Joseph Summerill, director of the Summerill Group LLC, a Washington, D.C.- based law enforcement think tank and general counsel for the Major County Sheriffs’ Association, made our job easy by using all five in one op-ed piece published today in the Washington Examiner entitled, “Facts on medical marijuana are stubborn things, too“.

Lie #1) Marijuana’s not really medical.  The government says so!

[M]arijuana is a Schedule I drug… a high potential for abuse or dependency… no accepted medical value… unsafe to use, even under medical supervision.  [M]arijuana has not passed the rigid scrutiny of medicine proposed by the FDA.

The Truth

• National Institutes of Drug Abuse (NIDA) puts the lifetime dependence rate on cannabis at 9%, same as caffeine.  Alcohol has a 15% rate of abuse and Tobacco’s is 32%.
• One third of federal jurisdictions (16 states and DC) accept the medical value of cannabis.
• The federal government is supplying four Americans with this “unsafe” medicine with no medical supervision.
• Cannabis has been used medically for 5,000 years without a single human death – a far greater safety standard than an FDA that approved phen-fen and Vioxx.

Lie #2) Doctors and scientists don’t approve of smoked medicine; they do approve of Marinol.

Institute of Medicine and the American Medical Association acknowledged the lack of data to support the use of smoked marijuana for medicinal purposes.

What is scientifically approved by the FDA and accepted by the medical community is a medicine called Marinol, a legal, widely prescribed drug currently in pill form containing synthetic THC, a main constituent in marijuana.

The Truth

• The American Medical Association said, “smoked cannabis reduces neuropathic pain, improves appetite and caloric intake especially in patients with reduced muscle mass, and may relieve spasticity and pain in patients with multiple sclerosis.”
• Marinol is 100% synthetic THC (the psychoactive component) suspended in a sesame oil capsule.  Cannabis flowers are around 5%-30% natural THC combined with CBD (a component that moderates psychoactivity) and other beneficial compounds.
• Inhaling cannabis is a superior delivery mechanism for it allows the patient to self-titrate (adjust dose) and get immediate relief.  It’s especially helpful to inhale cannabis rather than swallow a Marinol pill when one is vomiting.  We recognize many inhaled medications (think: steroid inhalers for asthma patients) and when vaporized, any harms from smoking cannabis are eliminated.

Lie #3) Marijuana smoke is much worse than cigarette smoke!

[S]moked marijuana contains more than 400 chemicals, many of which are identical to the most harmful chemicals and carcinogens found in cigarette smoke. The fact is that a marijuana cigarette contains four times as much tar as a tobacco cigarette.

The Truth

• My pencil contains five components, two of which are identical to the graphite found in golf clubs and the wood found in golf tees.  This does not make my pencil a golf club or a tee.  Water contains hydrogen and oxygen.  This does not make water flammable or breathable.  Many recipes call for the same ingredients; it’s how you put them together that matters.  Joints aren’t cigarettes, they’re far safer than that.
• Dr. Donald Tashkin went looking for that “marijuana causes cancer” connection and found quite the opposite, that cannabis smokers had lower incidence of head, neck, and lung cancer.  We even have compelling evidence that cannabinoids may be instrumental in unlocking the cure for cancer.
• Very few tokers smoke 20 to 40 joints a day, but even if they did, where are these marijuana smokers with the tar-ravaged lungs filling up our hospitals?  Again, we have zero recorded deaths from cannabis smoking and over 400,000 annual deaths from tobacco use.  Joints aren’t cigarettes.

Lie #4) Marijuana is the gateway drug to cocaine, meth, and heroin!

[L]egalizing marijuana leads to the use of more dangerous and harmful drugs, such as cocaine and methamphetamine…. [T]eens who smoke marijuana were found to be 85 times more likely to use cocaine than those teens who do not smoke marijuana.

The Truth

• Teens who ride bicycles were found to be 85 times more likely to join an outlaw biker gang than teens who don’t ride bicycles*.  So we should outlaw bicycles?  Sure, most cocaine users may have started first with pot, but they also probably started with alcohol before that and milk before that.
• That same Institute of Medicine report Mr. Summerill referenced in Lie #2 said, “There is no conclusive evidence that the drug effects of marijuana are causally linked to the subsequent abuse of other illicit drugs.”
• According to the National Survey on Drug Use and Health, over 100 million American adults have tried cannabis.  There are currently about 1.5 million monthly cocaine users, 430 thousand monthly meth users, and 192 thousand monthly heroin users.  So for every 46 people who’ve ever tried pot, only one went on to become a monthly hard drug user.  A gateway that only affects 2.1% of the people isn’t much of a gateway.

* OK, that one we just made up.

Lie #5) Marijuana legalization leads to carnage on the highways!

[M]arijuana use, including its use for medicinal purposes, is directly related to motor vehicle accidents and reckless driving, as cannabis affects psychomotor functioning.

In a study of fatally injured drivers in Washington state, a state with legalized medical marijuana, about one every eight tested positive for marijuana.

The Truth

• The National Highway Traffic Safety Administration has said of marijuana testing of drivers, “It is inadvisable to try and predict effects based on blood THC concentrations alone, and currently impossible to predict specific effects based on THC-COOH concentrations” because “[d]etection time is well past the window of intoxication and impairment.” Finding pot in some drivers’ systems following a crash just tells you some people smoke pot.
• From 2008-2009, fatal crashes in the states that had medical marijuana declined overall 9.34%.  Only one medical marijuana state, Rhode Island, had an increase greater than 3%, which resulted in 18 more deaths.  Four other states had 1%-3% increases, leading to 9 additional deaths.  Of the remaining eight states that saw declines, half saw double-digit declines, including the laxest medical marijuana state, California, which had 353 fewer traffic fatalities.
• Legalizing marijuana does not legalize DUI.  People who smoke pot and drive now are busted in all fifty states and legalization doesn’t change that.

When it comes to medical information and the safety record of cannabis, we’ll trust real doctors and 5,000 years of historical use.  Not the ramblings of a law enforcement think tank director desperately trying to save asset forfeiture proceeds, federal grant money, and overtime hours for state and local cops and job security for prison guards.

Author: Publius*

Most patients don’t get asked where they get their medicine. That’s because everyone knows people get their medicine from a pharmacy. But I have to get my medicine otherwise. I have to safeguard my “source” because my medicine is cannabinoid based – and that makes it almost illegal.  – But not today.  Today I can answer the source question openly because it is my local pharmacy – with drive-thru service and open to dispense medicine 24 hours a day. I drive up and push a big, yellow smiley-faced button to gain access – a soft automated voice comes over the speaker to verify that I am in the right place in order to pick up my prescription. Next, the typical professional looking person – white coat with badge – slides open the window asking my name and what I need.

“I’m picking up a prescription for Publius.”

They return with a baggie and bottle containing 30 synthetic cannabinoid capsules dosed at 5mg each – that’s right, legal cannabinoids!

What are cannabinoids? Well, here is where things get interesting. As one learns in biology, the human body has many systems – the circulatory, respiratory, digestive, and nervous systems to name a few. Each system has parts: for example, the nervous system is made up of the brain, spinal cord, and nerves. By the late 1980s, science identified a new human system – the endocannabinoid system (ECS) – also referred to as the cannabinoid system. There is a cannabinoid system present in all mammals – to include humans and 15,000 other species.  A mammal is any vertebrate animal distinguished by self-regulating body temperature, hair, and milk-producing females – as mammal means “breast” or of the breast.

The ECS has two main parts: cannabinoids, which are chemical neurotransmitters, and two receptors called “CB1″ and “CB2.” Cannabinoids activate receptors found throughout the body – in all organs, for example. In fact, all systems in our bodies are modulated by the cannabinoid system. This means that as a body system changes, it uses the ECS to do so.

Science and popular search sites like Wikipedia use three classifications of cannabinoids:

1.  Endogenous cannabinoids (also referred to as endocannabinoids), which are produced by the human body

2.  Herbal cannabinoids, the kind found in the cannabis sativa plant

3.  Synthetic cannabinoids, produced and distributed by pharmaceutical companies

The third kind is what I am picking up from the pharmacy – 30 Marinol (Dronabinol) capsules. Marinol is a prescribed cannabinoid from my doctor – and I am going to test it against the herbal cannabinoids I have been baking into my brownies for five years now.

The pharmacist hands me a white paper bag containing the Marinol prescribed for my Multiple Sclerosis (MS). Stapled to the top is a typical handout with cautionary medical information. The small amount (150mg) of the synthetic cannabinoid THC costs $370 – or more than $69,000 per ounce!

I sign my name on a distribution sheet and pay my $3 Medicare co-pay. The government, meaning our tax dollars, pays the other $367 for my medicine.  Now I am ready to go – but not before my ‘synthetic cannabinoid’ dealer informs me of possible side effects. She warns me to be on the lookout for – “dizziness, drowsiness, confusion, feeling ‘high,’ an exaggerated sense of well-being, lightheadedness, headache, red eyes, dry mouth, nausea, vomiting, stomach pain, clumsiness, or unsteadiness.”

Geez – sounds like a lot of potential adversity on my chemically sensitive body.  From personal experience, I know that the herbal cannabinoids do not cause these side effects in my body. The pharmacist did mention one noticeable side effect that I have had with eating cannabis brownies: dry mouth – which is hardly a problem when considering the overall benefits of the medicine.

When I get home I open the bag to take a look at the Marinol. The pills are a deep maroon color and perfectly round. They remind me of Boston Baked Beans – as they look exactly like those candies. One thing is for sure: synthetic cannabinoids do not look anything like herbal cannabinoids – the ones from the plant itself. The distinct medical difference of popping pills versus the variations and qualities of consuming natural cannabis cannot be understated – and surely won’t be by me. After a week of taking one pill a night before bed, as the doctor prescribed, I do not notice any positive effects from the Marinol. It makes me hungry – but that was never a problem in the first place. However, it is my first legal cannabinoid and that is what counts, right? – Not whether it works, just whether it is legal, right?

Wrong.

Here is what I know.  I have been self-medicating with herbal cannabinoids for five years to provide relief from MS, which I have had for 23 years.  During that time I went through the long list of prescribed pharmaceuticals.  The relief was minimal. The problem was (and is) the side effects, which became unbearable over time. I felt like a slave, dependent on a cycle of pharmaceutical use which abused my body and left me in the most depressed, hopeless, and flattened state.

I finally said enough of the pharma-tinkering with my body and the MS and tried baking herbal cannabinoids into brownies. In doing so, my alternative treatment made me a criminal. I began to eat a small cube of cannabis brownie three times a day. Within the first month my insomnia disappeared, my bladder issues calmed, nerve tingles of the arms, legs, and feet stilled. I was no longer breaking out in upper body tremors after being out in the world of loud noises, traffic, and the everyday racing of life.  The MS was quieter. I found I wasn’t contemplating suicide and I felt hopeful about my life again – but realized I had become a chronic criminal.

Cannabinoids are clearly medicinal to our bodies. But there is a strange distinction between which cannabinoids are effective and which ones are legal.  In the case of my MS, appetite stimulation has not been a problem – which is what the Marinol is usually prescribed for. Marinol simply did not work for me. There are other pharmaceutical cannabinoids – such as Nabilone and Sativex – available in other countries, but they remain expensive and less effective than herbal cannabinoids.  Nature created cannabis and the mammalian ECS, not you or me – and it was through the use of herbal cannabinoids that I was able to wean myself from a life of pharma-cocktails and move toward a healthier life. – Just as nature designed.

This is the first chapter of book in progress titled The Cannabis Papers being published by Illinois NORML.

More chapters are available for review here.

*Publius is Bryan Brickner, Julie Falco, Dianna Lynn Meyer, Stephen Young, William Abens, Danielle Schumacher, Derek Rea (1954-2008), David Nott, Dan Linn, Dan S. Wang, Brian Allemana, and many others.

Mitch Earleywine, and former deputy drug czar under Bush 1.0 Herb Kleber, which strongly underlines the differences between credible and not credible on the topic of cannabis.

Credible:

[One] problem with Marinol is that it’s orally administered,” Dr. Mitch Earleywine, an associate professor of Clinical Psychology at the State University of New York at Albany, said in an email. “Therefore, it takes longer to work than cannabis inhaled from a vaporizer. (Usually 90 minutes at best rather than 15 seconds – a meaningful amount of time to the nauseated.)”

“It’s harder to control dosage, too, so folks end up discombobulated or without symptom relief,” he added. “In addition, folks who are vomiting can’t hold down the pills.” Earleywine also said that a dose Marinol costs three to five times as much as a comparable dose of medical marijuana.

Not Credible:

“Are there actions in the whole plant that you don’t get from just the Marinol? I would be surprised if there wasn’t,” he continued. “The problem is that most of the data about the potential medical actions of the smoked form are anecdotal.”

Dr. Kleber, who said he has prescribed Marinol to a patient and found it to be effective, points to what he characterizes as a significant advantage of the pill over traditional marijuana: “People don’t abuse it.”

“Marijuana addiction is becoming common and as a result I’m seeing an increasing number of people who have trouble stopping marijuana,” he said. “Contrary to popular beliefs that there is no marijuana withdrawal, there is marijuana withdrawal. It’s very clear cut.”

Talk about anecdotal! Dr. Kleber would have readers believe, that cannabis today, as compared to the prior 2,000 years of documented cannabis use by humans is that “Marijuana addiction is becoming common”.

Really?

“I’m seeing an increasing number of people who have trouble stopping marijuana”

Of course you are Herb because as it has been well documented by NORML that the criminal justice system throughout most of the United States presents minor cannabis offenders with the Hobson’s Choice of either going to jail or to visit the offices of the ‘Dr. Klebers’ in America for ‘treatment’.

Dr. Kleber well knows this, so his statement is for me the working definition of disingenuous!

Lastly, there is nothing new about Marinol as it has been legal and available for medical patients since the mid 1980s. If the pill worked as Dr. Kleber claims, voters and legislators in the 13 states with medical cannabis laws would not have opted for a whole plant solution.

Marinol was supposed to be the government’s great ‘silver bullet’ back in the mid 1980s to end the public debate about patients’ need for whole-smoked cannabis–an analog of one of the plant’s major ingredients isolated in pill form.

Want to know more about ‘pot’ pills vs. the real thing? Checkout NORML’s published paper ‘Marinol vs. Natural Cannabis‘.

Does the Pot Pill Work?
The Government Says a Pill Called Marinol Offers the Same Benefits as
Medical Marijuana. Is it True?

By Brian Montopoli
August 4, 2009

(CBS) “Medical marijuana,” the U.S. Drug Enforcement Administration says, “already exists.”

They don’t just mean in California. A pill known as Marinol has been legal and approved by the Food and Drug Administration for use with a prescription anywhere in America since 1985.

It’s active ingredient? Dronabinol, better known as THC, the primary psychoactive element of the cannabis plant.

“Marinol provides standardized THC concentrations, does not contain the other 400 uncharacterized substances found in smoked marijuana, such as carcinogens or fungal spores, and is not associated with the quick high of smoked marijuana,” said Neil Hirsch, a spokesman for Marinol manufacturer Solvay Pharmaceuticals.

But Marinol is not the same thing as traditional, smokable marijuana. It is a less complex substance lacking both some of the good components found in traditional marijuana (such as cannabidiol, which has been found to have anti-seizure effects) and the bad or not-yet-fully-understood components (among them potential carcinogens) that can also come with the drug.

Ken Trainer, a 60-year-old Massachusetts resident who has battled Multiple Sclerosis for 25 years, said he has long been smoking marijuana to deal with the regular tremors he gets in his arms and legs.

“If I smoke a joint, the tremors go away most times before the joint is gone,” he said. “It makes my life a little easier.” Marinol, by contrast, “didn’t really do much of anything for me,” he said.

56-year-old Des Moines resident Jeff Elton, who was diagnosed with gastroparesis six years ago, had a similar experience when he was prescribed Marinol to deal with his chronic nausea and vomiting.

“I felt no relief, I didn’t feel ill, I felt nothing,” he said. “It might as well be M&M’s.”

Elton said he switched to marijuana, which he smokes through a vaporizer – a device that heats the active ingredients into a vapor instead of burning them. He said it allows him to keep down his food and regain some of the weight he lost while on Marinol.

“[One] problem with Marinol is that it’s orally administered,” Dr. Mitch Earleywine, an associate professor of Clinical Psychology at the State University of New York at Albany, said in an email. “Therefore, it takes longer to work than cannabis inhaled from a vaporizer. (Usually 90
minutes at best rather than 15 seconds – a meaningful amount of time to the nauseated.)”

“It’s harder to control dosage, too, so folks end up discombobulated or without symptom relief,” he added. “In addition, folks who are vomiting can’t hold down the pills.” Earleywine also said that a dose Marinol costs three to five times as much as a comparable dose of medical marijuana.

Defenders note that Marinol is not meant to be a cure-all: It has been approved specifically for treating nausea and vomiting associated with cancer chemotherapy and for treating anorexia associated with weight loss in patients with AIDS.

“When the whole push for the smoked product came along, it was often for those two indications,” said Dr. Herbert Kleber, a professor of Psychiatry at Columbia University and the former deputy drug czar under President George H.W. Bush. “And in general, I’ve not seen any need for the smoked form of marijuana for those two indications. Marinol had already been shown to be quite effective for those two things.”

“Are there actions in the whole plant that you don’t get from just the Marinol? I would be surprised if there wasn’t,” he continued. “The problem is that most of the data about the potential medical actions of the smoked form are anecdotal.”

Research into the effects of medical marijuana is ongoing: The University of California, San Diego, for example, boasts a Center for Medicinal Cannabis Research engaged in “focused controlled clinical trials on the efficacy of cannabis in patients diagnosed with HIV/AIDS,
cancer, seizures or muscle spasms associated with a chronic debilitating condition, or any other serious condition providing sufficient theoretical justification.” (The director of the UCSD program, Dr. Igor Grant, was out of the country and could not be reached for this story.)

The Los Angeles Times, which offers a nice overview of the current research, writes that “a growing body of research supports [medical marijuana's] medical usage, but some of it is cautionary.” Marijuana has been found to be effective in counteracting severe pain, nausea and loss of appetite, though questions remain about the drawbacks, among them possible respiratory damage and increased cancer risk.

Dr. Kleber, who said he has prescribed Marinol to a patient and found it to be effective, points to what he characterizes as a significant advantage of the pill over traditional marijuana: “People don’t abuse it.”

“Marijuana addiction is becoming common and as a result I’m seeing an increasing number of people who have trouble stopping marijuana,” he said. “Contrary to popular beliefs that there is no marijuana withdrawal, there is marijuana withdrawal. It’s very clear cut.”

The calculus, then, isn’t quite as simple as the Drug Enforcement Administration suggests: Marinol and medical marijuana may share an active ingredient, but they offer somewhat different benefits and different drawbacks. Proponents of medicinal marijuana say it’s disingenuous to hold up Marinol as a direct alternative to the more traditional form of the plant.

“I just don’t understand how they won’t let me smoke a joint, but they’re more than happy to write me out prescriptions for anything that I want,” Trainer said.

By Dale Gieringer, Ph.D, Director, California NORML

California NORML has recently heard increasing reports that Marinol patients are being drug tested and denied employment for use of marijuana. In particular, we have heard from legal Prop. 215 patients who were denied jobs despite presenting Marinol prescriptions after being re-tested specifically for marijuana. Until recently, Marinol and marijuana were indistinguishable on the standard drug tests, so that patients with a Marinol prescription had a valid medical excuse under federal law for testing positive for marijuana.

However, special testing techniques have been developed that make it possible to distinguish the two by testing for non-standard cannabinoids that appear in marijuana but not Marinol. Until recently, these tests were expensive and rarely used except in high-profile criminal cases. However, it appears that they are now being routinely used by certain laboratories in cases where Marinol use is claimed. In particular, we have heard reports of such testing being used to disqualify Marinol-using Prop 215 patients by the transportation industry and by Walmart.

California NORML has accordingly altered its drug testing information to warn against relying on Marinol RXs as a screen for marijuana use: http://www.canorml.org/healthfacts/testing.tips.html

There is of course no valid scientific or health justification for allowing patients to use Marinol but not marijuana. The only purpose is to enforce compliance with the law. It is a tribute to the power and influence of the drug testing industry that they have prevailed in foisting the costs of this unnecessary and obnoxious procedure on employers.

California NORML, 2215-R Market St. #278, San Francisco CA 94114

(415) 563-5858 / www.canorml.org

Investigators at the University of Mississippi report the discovery of eleven new non-cannabinoid constituents in cannabis, several of which possess “anti-microbial” (think MRSA), “anti-malarial,” and “anti-leishmanial” (a common skin parasite) activity. Scientists also reported that several of the compounds also possessed anti-inflammatory properties and acted as potent anti-oxidants.

(The US government, Depart of Health and Human Services actually holds a patent on the use of certain cannabinoids as anti-oxidants and neuroprotectants, which you can read here.)

In other words, when we speak about the healing powers of the cannabis plant, we really mean the entire cannabis plant. We’re not talking about isolating particular cannabinoids, and we’re most certainly not suggesting patients be forced to consume an oral synthetic version of a single compound a la Marinol.

Therapeutic cannabis means just that — the therapeutic prowess of the whole plant. We should not advocate for, or accept, anything less.

The US government’s longstanding denial of medical marijuana research and use is an irrational and morally bankrupt public policy. On this point, few Americans disagree. As for the question of “why” federal officials maintain this inflexible and inhumane policy, well that’s another story.

One of the more popular theories seeking to explain the Feds’ seemingly inexplicable ban on medical pot — and the use of cannabis by adults in general — goes like this: Neither the US government nor the pharmaceutical industry will allow for the use of medical marijuana because they can’t patent it or profit from it. A related, yet equally common hypothesis argues: Big Pharma lobbies the federal government to keep pot illegal because it won’t be able to compete with patients growing their own medicine.

They’re appealing theories, yet I’ve found neither to be accurate nor persuasive. Here’s why.

First, let me state the obvious. Big Pharma is busily applying for — and has already received — multiple patents for the medical properties of pot. (The US government has too, but that’s a different story all together.) These include patents for synthetic pot derivatives (such as the oral THC pill Marinol), cannabinoid agonists (synthetic agents that bind to the brain’s endocannabinoid receptors) like HU-210 and cannabis antagonists such as Rimonabant. This trend was most recently summarized in the NIH paper, “The endocannabinoid system as an emerging target of pharmacotherapy,” which concluded, “The growing interest in the underlying science has been matched by a growth in the number of cannabinoid drugs in pharmaceutical development from two in 1995 to 27 in 2004.”

In other words, at the same time the American Medical Association is proclaiming that pot has no established medical value, Big Pharma is in a frenzy to bring dozens of new, cannabis-based medicines to market.

Not all of these medicines will be synthetic pills either. Most notably, GW Pharmaceutical’s oral marijuana spray, Sativex, is a patented standardized dose of natural cannabis extracts. (The extracts, primarily THC and the non-psychoactive, anxiolytic compound CBD, are taken directly from marijuana plants grown at an undisclosed, company warehouse.)

Does Big Pharma’s sudden and growing interest in the research and development of pot-based medicines mean that the industry is proactively supporting marijuana prohibition? Not if they know what’s good for them.

First, any and all cannabis-based medicines must be granted approval from federal regulatory bodies such as the US Food and Drug Administration — a process that remains as much based on politics as it is on scientific merit. Chances are that a government that is unreasonably hostile toward the marijuana plant will also be unreasonably hostile toward sanctioning cannabis-based pharmaceuticals.

A recent example of this may be found in the Medicine and Health Products Regulatory Agency’s recent denial of Sativex as a prescription drug in the United Kingdom. (Sativex’s parent company, GW Pharmaceuticals, is based in London.) In recent years, British politicians have taken an atypically hard-line against the recreational use of marijuana — culminating in Prime Minister Gordon Brown’s declaration that today’s pot is now of “lethal quality.” (Shortly thereafter, Parliament elected to stiffen criminal penalties on the possession of the drug from a verbal warning to up to five years in jail.)

In such an environment is it any wonder that British regulators have steadfastly refused to legalize a pot-based medicine, even one with an impeccable safety record like Sativex? Conversely, Canadian health regulators — who take a much more liberal view toward the use of natural cannabis and oversee its distribution to authorized patients — recently approved Sativex as a prescription drug.

Of course, gaining regulatory approval is only half the battle. The real hurdle for Big Pharma is finding customers for its product. Here again, a culture that is familiar with and educated to the use therapeutic cannabis is likely going to be far more open to the use of pot-based medicines than a population still stuck in the grip of “Reefer Madness.” (For example, Marinol, despite having been approved by the FDA in 1986, was rescheduled so that doctors might prescribe it more liberally in 1999 — three years after California and other states began approving medical marijuana use legislation. Coincidence? I doubt it.)

Will those patients who already have first-hand experience with the use of medical pot switch to a cannabis-based pharmaceutical if one becomes legally available? Maybe not, but these individuals comprise only a fraction of the US population. Certainly many others will — including many older patients who would never the desire to try or the access to obtain natural cannabis. Bottom line: regardless of whether pot is legal or not, cannabis-based pharmaceuticals will no doubt have a broad appeal.

That said, many argue that the legal availability of pot would encourage patients to use fewer pharmaceuticals overall and significantly undercut Big Pharma’s profits. To a minor degree this may be a possibility, though likely not to an extent that adversely impacts the industry’s bottom line. Certainly most individuals in the Netherlands, Canada, and in California — three regions where medical pot is both legal and easily accessible on the open market — use prescription drugs, not cannabis, for their ailments. Further, despite the availability of numerous legal healing herbs and traditional medicines such as Echinacea, Witch Hazel, and Eastern hemlock most Americans continue to turn to pharmaceutical preparations as their remedies of choice.

Should the advent of legal, alternative pot-based medicines ever warrant or justify the criminalization of patients who find superior relief from natural cannabis? Certainly not. But, as the private sector continues to move forward with research into the safety and efficacy of marijuana-based pharmaceuticals, it will become harder and harder for the government and law enforcement to maintain their absurd and illogical policy of total pot prohibition.

Needless to say, were it not for advocates having worked for four decades to legalize medical cannabis, it’s unlikely that anyone — most especially the pharmaceutical industry — would be turning their attention toward the development and marketing of cannabis-based therapeutics. That said, I won’t be holding my breath waiting for any royalty checks.

So, if Big Pharma isn’t a significant player in the ongoing prohibition of the personal use of cannabis, then who is responsible? Based on my experience, the answer is obvious. First and most importantly, there’s federal government — as represented not only by the lawmakers who continue to vote in favor of America’s Draconian drug policies, but also the numerous acronymn ladened bureaucracies (such as the ONDCP, NIDA, etc.) who actively lobby against any change in direction.

The second most powerful player in maintaining pot prohibition? That’s easy: law enforcement, as represented by bigwigs like the US Drug Enforcement Administration and the California Narcotics Officers Association, all the way down the line to small-town police forces — all of whom consistently finance efforts to derail any relaxation of federal, state, or local marijuana policies.

The third and final primary player responsible for maintaining modern-day pot prohibition? Unfortunately, that would be us, the general public — a majority of whom have repeatedly voiced disapproval for legalizing the use personal use of pot by adults in both national polls and on statewide ballot initiatives, most recently in Colorado and in Nevada in 2006. (By contrast, more than half of Americans do support — and have consistently voted for — legislation in support of the qualified medical use of cannabis by authorized patients.)

In short, until there is a significant sea-change in the attitudes and actions of the Feds, cops, and the general public, expect prohibition — particularly the broader prohibition on the recreational use of cannabis — to continue.