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Federal Officials Respond to New Medical Marijuana Laws


January 1997

The Clinton Administration came under steady, intense criticism by Republicans for not fighting drugs aggressively during its first term, a period during which surveys showed an increase in teenage marijuana use. In November, White House officials promised to respond to Proposition 215 and Proposition 200. Following a review of the laws, the White House announced counter measures, but did not propose new legislation or spending. The Clinton Administration claims that these laws undermine the nation's anti-drug policies and encourage adolescent marijuana use.


On December 12, federal officials issued their first specific response, warning that under federal law a doctor's prescription or recommendation for marijuana does not excuse transportation workers -- such as pilots, truck drivers and bus drivers -- who test positive for marijuana use. "If you are entrusted with the safety of the traveling public and you test positive [for marijuana], these propositions don't mean a thing," said Transportation Secretary Federico Pena. "You will be removed." (Elizabeth Shogren, "U.S. Officials Issue Prop. 215 Warning," Los Angeles Times, December 13, 1996, p. A3; Elizabeth Shogren, "U.S. Transport Workers Can't Avoid Drug Tests," San Francisco Chronicle, December 13, 1996, p. A3)

The warning is not a change in federal law. Drug testing of the nation's 8 million transportation workers has been federal law since 1988. These employees are tested before being hired, randomly during employment, and if they are involved in an accident. "This is unsurprising non-news," said Dave Fratello, a spokesman for Americans for Medical Rights, an organization that campaigned for California's Proposition 215. "To say that federal laws still apply doesn't surprise anybody. To say safety rules still apply is obvious to anyone who read the proposition's text," said Fratello.


On CBS' "Face the Nation," (Dec. 29, 1996) White House "drug czar" Barry McCaffrey announced that on December 30 the Administration will send letters to every doctor in Arizona and California, warning them that they face revocation of their registration with the DEA if they recommend or prescribe marijuana. DEA registration allows doctors to prescribe drugs classified as Schedule II through Schedule IV. Under federal law, doctors can only prescribe Schedule I controlled substances, including marijuana, with a special license. However, officials said there will not be a widespread effort to investigate and punish those doctors, unless they prescribe marijuana in amounts so large that they in effect are acting as drug dealers. Officials said criminal prosecution of doctors is also a possibility (Peter Baker and William Claiborne, "Plan Targets Medical Use of Marijuana," Washington Post, December 29, 1996, p. A1).

"There's no way I can recommend [marijuana] now without risking my livelihood. It's a threat to my license to write prescriptions, and if I can't write prescriptions, I'm out of business," said Richard Cohen, MD, a San Francisco oncologist who actively supported Proposition 215. Cohen added, "It means that there will be patients whose quality of life will be worse than it should be." Other doctors expressed worry about being excluded from receiving Medicare and Medicaid payments. Americans for Medical Rights said it will file suit to block punishment of doctors who advise their patients that marijuana would be beneficial, charging that the administration's actions have violated doctors' constitutional right to free speech (William Claiborne, "Federal Warning on Medical Marijuana Leaves Physicians Feeling Intimidated," Washington Post, January 1, 1997, p. A6).

Ironically, Proposition 215 may make marijuana less available to Californians with medical needs by provoking a federal reaction against doctors who have been recommending marijuana to their patients for years despite the legal risks. Most medical marijuana cases in California have not been prosecuted, and according to the California Medical Board, no complaint has ever been filed against a doctor who recommended the drug. Fratello admits, "By calling so much attention to this issue, we may have inadvertently put doctors at some risk. We may have reduced the willingness of some doctors to recommend marijuana for legitimate medical use."


Officials also warned that businesses receiving federal money that fail to maintain a drug-free workplace will risk losing their federal contracts and grants. In addition, officials said the Administration will let Congress decide if Arizona and California should lose federal funding for drug rehabilitation and other drug programs.

The Administration said it decided not to contest the state laws in court, though the laws appear to contradict federal laws prohibiting the possession and use of marijuana. Justice Department officials said they found no firm constitutional or statutory grounds for challenging the laws.

Federal officials acknowledged that they lack the resources for more aggressive enforcement measures. Senior officials said they rejected tactics such as dispatching federal agents to Arizona and California for fear of appearing heavy-handed and prompting a backlash against Washington. Attorney General Janet Reno said that state and local law enforcement will continue to handle most small marijuana cases. According to the Washington Post, Reno said that "the federal government will get involved in cases where a defendant in a drug case argues his innocence based on the fact that the drugs were given him by a doctor." (Roberto Suro, "U.S. Will Issue Warnings On Medical Marijuana Laws," Washington Post, December 31, 1996, p. A1.)

Supporters of the propositions denounced the Administration's response, saying that it is insensitive to terminally and seriously ill patients who use medical marijuana. They also contend that it ignores the substantial evidence supporting marijuana's therapeutic benefits for AIDS, glaucoma, cancer, multiple sclerosis and many other conditions. "It's outrageous, it goes against the Hippocratic oath," said Lester Grinspoon, MD, a professor of psychiatry at Harvard University and author of two books on medical marijuana. Grinspoon continued, "My responsibility as a physician is to provide the best relief I can. In some circumstances, that comes from marijuana." A national survey in 1991 by researchers at the Kennedy School of Government at Harvard reported that 44% of physicians said they had recommended marijuana to patients. "Are they talking about arresting 44% of the physicians in Caliornia?" asked Jon Holmes, Chairman of the Drug Policy Unit for the ACLU of Massachusetts. "Surely we have better things to do with our prison cells. To arrest either the doctors or the users is absurd" (Kate Zernike, "White House Fights Medical Marijuana," Boston Globe, December 30, 1996, p. A1).

Other articles used in this report include: Joyce Price, "U.S. will encourage doctors not to dispense medical pot," Washington Times, December 30, 1996, p. A3; "Clinton OKs plan to fight laws legalizing pot for medical use," Virginian-Pilot, December 30, 1996, p. A6; Associated Press, "Doctors Given Threat on Marijuana," New York Times, December 31, 1996, p. A1; Kevin Johnson, "Doctors told not to prescribe marijuana," USA Today, December 31, 1996, p. A1; Glen Elsasser, "Dismissing medical uses, U.S. fights pot initiatives," Chicago Tribune, December 31, 1996, p. A1.