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Medical Marijuana: Review and Analysis of Federal and State Policies


The issue before Congress is whether to continue the federal prosecution of medical marijuana patients and their providers, in accordance with the federal Controlled Substances Act (CSA), or whether to relax federal marijuana prohibition enough to permit the medicinal use of botanical cannabis products when recommended by a physician, especially where permitted under state law.

The first action on medical marijuana in the current Congress occurred in April 2007, at markup of the Prescription Drug User Fee Act (S. 1082). The Senate Committee on Health, Education, Labor, and Pensions adopted an amendment, not included in the enacted bill, requiring “that State-legalized medical marijuana be subject to the full regulatory requirements of the Food and Drug Administration.”

Then, in July 2007, the Hinchey-Rohrabacher amendment to prevent federal enforcement of the CSA against medical marijuana users and providers in the states that have legalized its use was rejected by the full House by a vote of 165 to 262.

In the second session of the current Congress, Representative Barney Frank introduced H.R. 5842, a bill that would allow the medical use of marijuana in states that permit its use with a doctor’s recommendation. The Medical Marijuana Patient Protection Act would move marijuana from Schedule I to Schedule II of the CSA and exempt from federal prosecution authorized patients and medical marijuana providers that are acting in accordance with state laws.

Thirteen states, mostly in the West, have enacted laws allowing the use of marijuana for medical purposes, and many thousands of patients are seeking relief from a variety of serious illnesses by smoking marijuana or using other herbal cannabis preparations. Meanwhile, the federal Drug Enforcement Administration refuses to recognize these state laws and continues to investigate and arrest, under federal statute, medical marijuana providers and users in those states and elsewhere.

Claims and counterclaims about medical marijuana — much debated by journalists and academics, policymakers at all levels of government, and interested citizens — include the following: Marijuana is harmful and has no medical value; marijuana effectively treats the symptoms of certain diseases; smoking is an improper route of drug administration; marijuana should be rescheduled to permit medical use; state medical marijuana laws send the wrong message and lead to increased illicit drug use; the medical marijuana movement undermines the war on drugs; patients should not be arrested for using medical marijuana; the federal government should allow the states to experiment and should not interfere with state medical marijuana programs; medical marijuana laws harm the federal drug approval process; the medical cannabis movement is a cynical ploy to legalize marijuana and other drugs.

With strong opinions being expressed on all sides of this complex issue, the debate over medical marijuana does not appear to be approaching resolution.

This report will be updated as legislative activity and other developments