Seeds of U.S. Pot Debate Were Sown in State

California has long been at the center of the medical marijuana debate. In June, the state drew attention after a U.S. Supreme Court decision denied two California women protection against federal prosecution for using medicinal cannabis.

Fallout from the court case has been widespread. Some dispensaries shut down growing operations, and supporters held protests.

Question: When did the controversy over medical marijuana begin?

Answer: For years an accepted part of Western medicine, cannabis has been out of the mainstream since the 1930s. But in recent decades, marijuana reemerged as an alternative therapy, particularly among AIDS patients, who said it helped stem the wasting effects of the disease.

The biggest shift toward public acceptance came in 1996, when California voters approved Proposition 215 with 56% of the vote. The measure made it legal for doctors to recommend marijuana to patients with serious illnesses. But the measure conflicted with federal law, which prohibits the use of cannabis for any purpose other than scientific research.

Opponents said the measure would invite abuse of a drug that had not been proved medically effective and would create confusion for law enforcement.

But the state’s voters decided otherwise, igniting a trend. Nine other states have also legalized medical marijuana.

Q: What did the Supreme Court do?

A: Angel Raich, an Oakland mother who uses medical marijuana for a variety of illnesses, joined with another patient, Diane Monson of Chico, to sue the federal government, hoping to win protection from federal prosecution.

In a classic states’ rights argument, the women said that their donated medical marijuana was grown in California and therefore not a product of intrastate commerce subject to federal jurisdiction.

The Supreme Court, in a 6-3 vote, didn’t buy the argument and upheld the federal government’s power to seize and destroy marijuana used as medicine by seriously ill patients.

In their dissent, some justices suggested that Congress or health regulators should revisit U.S. laws regarding marijuana as a medicine.

Q: What has the decision meant for California?

A: The case didn’t address the constitutionality of California’s law, so medical marijuana remains on the books in the state. Federal officials could conceivably arrest anyone for a marijuana violation, but the U.S. Drug Enforcement Agency almost always focuses on raiding big cannabis-growing operations. There are exceptions.

Steven McWilliams came to the attention of federal officials in 2002 through an act of civil disobedience -- distributing medical marijuana at San Diego City Hall.

McWilliams was arrested and convicted of cultivating 25 plants for his small medical marijuana collective and was facing jail time because the Supreme Court ruling undermined his appeal.

McWilliams committed suicide by overdosing on prescription drugs July 11. Americans for Safe Access, an Oakland group, staged memorial services for McWilliams in San Diego, Los Angeles and other cities across the country Tuesday.

Q: What does research show?

A: Federal regulators consider marijuana a Schedule 1 drug without medical benefit and susceptible to abuse. But medical marijuana activists have petitioned the government to have it reclassified as a Schedule 2 or 3 drug so doctors might eventually be allowed to prescribe it.

Proponents say there are thousands of scientific papers underscoring accepted and promising medicinal benefits.

But there are very few large clinical studies that prove a medicinal benefit.

Pot supporters contend the dearth of such research is the fault of a resistant federal government, which acts as a gatekeeper to such research. Federal authorities dispute such claims.

Q: Have doctors embraced marijuana for the masses?

A: Not exactly. Pharmacies don’t carry it, and any doctor who writes a prescription could jeopardize his or her federal license to administer drugs. Instead, doctors make recommendations, much as they might discuss a dietary supplement with a patient.

But many physicians still avoid recommending cannabis. Some don’t believe it works.

Others worry about the potential for abuse or fear retaliation from the federal government. Many are bothered by the absence of dosage and quality standards.

Q: Since pharmacies don’t have it, where do patients get their cannabis?

A: Some of California’s estimated 100,000 medical marijuana patients cultivate their own marijuana. But many others don’t have the expertise, space or, in the case of the very ill, the strength to cultivate the herb.

As a result, many patients have turned to storefront dispensaries or collectives that sell to patients with written recommendations.

This medical cannabis can come in a variety of forms -- liquid tinctures, candies, brownies and the regular leafy herb. Many patients use vaporizers, which allow them to inhale cannabis without having to breathe in carcinogenic smoke.

The dispensaries have become a target for federal raids, and in some cases, operators have been arrested.

Q: Has law enforcement been confused by Proposition 215?

A: Many officers and drug agents were confused early on. Since then, a series of state court cases has helped define the limits of the law. In urban areas, such as the Bay Area and Los Angeles, the issue has mostly receded as a policing priority. In rural areas, officers are more apt to make arrests and confiscate marijuana from people who claim patient status.

Medical marijuana supporters have also been troubled that California Highway Patrol officers have made similar seizures, and have filed suit to block that practice.

Q: Why did the state create photo IDs for users of medical marijuana?

A: The cards were intended to give patients a way to avoid trouble with police.

In the wake of the recent Supreme Court ruling, the state Health Department this month suspended the project out of fear the cards could make patients or the state a target for federal prosecution.

But the program was restarted Monday after Atty. Gen. Bill Lockyer advised health officials that state employees were not at risk. But Lockyer had less encouraging news for patients considering getting a card -- the information could potentially be used by federal officials in a prosecution.