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Abstract
Federal drug policy defines marijuana as a prohibited Schedule 1 substance—a dangerous drug carrying a high potential for abuse and no accepted medical use. This classification is largely due to the drug's well‐known psychoactive effects (‘the high’). Because of this, even medical marijuana advocates have tended to downplay the consciousness‐altering properties of cannabis when arguing for the medicinal utility of the drug. Advocates instead focus largely on the therapeutic potential of marijuana to relieve physical symptoms such as nausea, weight loss, or elevated ocular pressure. But interviews with more than three dozen seriously and terminally ill medical marijuana patients affiliated with one northern California cooperative, the Wo/Men's Alliance for Medical Marijuana, suggest that the consciousness‐altering effects of cannabis may play a significant role in what many patients report to be the therapeutic value of the drug.
Notes
[1] Dying to Get High will be co‐authored with Dr. Richard J. Webb. I thank him for research support for this article.
[2] Most interview subjects came forward as volunteers from the general WAMM membership; these initial interviews were supplemented with key person interviews, including interviews with the co‐founders of the organization, several members of the board of directors, and representatives of local law enforcement and elected officials. Targeted interviewing within WAMM was also employed to ensure that the interview sample reflected the diversity within the membership, including differences of race, class, gender, sexual orientation, and physical condition.
[3] As of the beginning of 2007, the other 10 medical marijuana states are Arkansas, Arizona, Colorado, Hawaii, Maine, Nevada, Oregon, Rhode Island, Vermont, and Washington.
[4] This is dark humor indeed, as it is unusual for a month to pass without the loss of a member or two; over 150 members have died since 1996.
[5] Donations of both time and money are encouraged but are not required. Indeed, most members make little if any monetary contribution to the organization—in part a reflection of the economic challenges that often accompany serious illness.
[6] The only other legal marijuana facility in the country is a farm at the University of Mississippi which operates under federal contract.
[7] Eleven states have currently legalized marijuana for medical use, although the drug is still illegal under federal law.
[8] The 1970 Controlled Substances Act established five schedules of controlled substances. Schedule 1 is reserved for drugs with the greatest potential for abuse and which have no recognized medical use. Schedule 1 drugs are strictly prohibited (see http://www.dea.gov/pubs/csa/812.htm).
[9] Dr. Mike Alcalay, a California physician, observes that both morphine and alcohol have a therapeutic index of 10—that is, 10 times the standard dose would be lethal. Tylenol and ibuprofen have a therapeutic index of around 25 or 30; penicillin is at about 100. However, a lethal dose of marijuana would be approximately 40,000 times the amount used to get high (Eskenazi, Citation2005). For additional discussion of this issue, see Sullum (Citation2003).
[10] In fact, in some circumstances so‐called ‘negative side‐effects’ may in themselves be therapeutic. The lead researcher in an Israeli study of the use of THC in the treatment of post‐traumatic stress disorder, for example, suggests that forgetfulness might be helpful in treating stress by ‘suppressing unwanted memories (Muwakkil, Citation2004).