High Times

Why Hillary Clinton's Plan for Marijuana Simply Doesn't Go Far Enough

Speaking late last year at a campaign stop in South Carolina, Democrat Presidential candidate Hillary Clinton pledged if elected President to reclassify marijuana under federal law from a Schedule I substance – the most restrictive category – to a Schedule II substance. 
 
Said Clinton: "The problem with medical marijuana is there is a lot of anecdotal evidence about how well it works for certain conditions. But we haven't done any research. Why? Because it is considered that is called a schedule one drug and you can't even do research in it."

She added, "I would like to move it from what is called Schedule I to Schedule II so that researchers at universities, national institutes of health can start researching what is the best way to use it, how much of a dose does somebody need, how does it interact with other medications."

Although Clinton’s call for rescheduling represents an improved willingness on her part to advocate for marijuana law reform, her newfound stance is hardly progressive. Various advocacy organizations, including NORML, High Times, and Americans for Safe Access, have filed administrative petitions over the past decades seeking to amend cannabis’ Schedule I status. Even among her peers, Clinton’s position isn’t unique. This past spring, former Republican Presidential candidate Rand Paul (KY) co-sponsored Congressional legislation, The Compassionate Access, Research Expansion, and Respect States (CARERS) Act, to move marijuana from Schedule I to II and to permit VA doctors to recommend cannabis therapy to veterans. One-time Democrat Presidential hopeful Martin O'Malley also campaigned on the pledge that he would use his executive powers to move cannabis to Schedule II. Most notably, Clinton’s leading Democrat Presidential rival Bernie Sander (I-VT) introduced Senate legislation, S. 2237, the Ending Federal Marihuana Prohibition Act, to strike both marijuana and ‘tetrahydrocannabinols’ (aka THC) from the federal criminal code, thus leaving the decision of whether or not to legalize and regulate cannabis solely up to the individual states.
 
While Sanders’ proposal would significantly transform America’s marijuana policies, Clinton’s rescheduling plan would actually do little to change the existing legal landscape. Moreover, Clinton’s premise that scientists have yet to do any research on cannabis is woefully incorrect.
 
Unlike conventional pharmaceuticals, the marijuana plant possesses an extensive history of human use dating back thousands of years, thus providing society with ample empirical evidence as to its relative safety and efficacy. Moreover, despite cannabis’ modern day politicization, the plant and its compounds have nonetheless been subject to extensive scientific scrutiny. A search using the term “marijuana” on the website of the National Library of Medicine, the repository for all peer-reviewed scientific papers, yields more than 23,000 scientific papers referencing the plant and/or its constituents. Among this extensive body of literature are over 100 randomized controlled studies, involving thousands of subjects, evaluating the safety and efficacy of cannabis or individual cannabinoids. A 2012 review of several FDA-approved gold-standard cannabis clinical trials concluded, “Based on evidence currently available the Schedule I classification (for cannabis) is not tenable; it is not accurate that cannabis has no medical value, or that information on safety is lacking.” 
 
In short, Clinton’s presumption that it is the absence of scientific research that necessitates the need to remove cannabis from Schedule I is both ill informed and unpersuasive. In truth, marijuana does not belong in Schedule I because ample scientific evidence already exists disproving the government’s claim that it is among the most dangerous substances known to man and that it lacks therapeutic utility. Moreover, reclassifying cannabis from I to II – the same category as cocaine – continues to misrepresent the plant’s safety relative to other controlled substances, and fails to provide states with the ability to regulate it free from federal interference.
 
Further, the federal policies in place that make clinical trial work with cannabis more onerous than it is for other controlled substances — such as the requirement that all source material be purchased from NIDA’s University of Mississippi pot program — are regulatory requirements that are specific to cannabis, not to Schedule I drugs in general. Simply rescheduling cannabis from I to II does not necessarily change these regulations. 
 
In addition, the sort of gold-standard, large-scale, long-term Phase III safety and efficacy trials Ms. Clinton ostensibly advocates for are prohibitively expensive. As a result, trials of this kind are typically are funded by private pharmaceutical companies aspiring to bring a new product to market. In some cases, the federal government may assist in sharing these costs. However, political reality dictates that neither entity is likely to pony up the tens of millions of dollars necessary to conduct such trials any time soon, if ever. 
 
This is not to say that rescheduling cannabis would not have any positive tangible effects. At a minimum, it would bring an end to the federal government’s longstanding intellectual dishonesty that marijuana ‘lacks accepted medical use.’ It would also likely permit banks and other financial institutions to work with state-compliant marijuana-related businesses, and permit employers in the cannabis industry to take tax deductions similar to those enjoyed by other businesses. But ultimately, such a change would do little to significantly loosen federal prohibition or to make herbal cannabis readily accessible for clinical study. These goals can only be accomplished by federally decsheduling cannabis in a manner similar to alcohol and tobacco, thus providing states the power to establish their own marijuana policies free from federal intrusion.
 

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Opponents of legalizing cannabis for medicinal purposes are fond of arguing that the plant must be subjected to the same standards of clinical study and FDA review as conventional medicines. What they fail to mention is that cannabis and its active components have already been subjected to a greater degree of scientific scrutiny than many FDA-approved pharmaceuticals.
 
According to a just-published analysis of some 200 newly FDA-approved medications, few conventional drugs are tested in multiple, large-scale clinical assessing safety and efficacy trials prior to market approval. “[A]bout a third won approval on the basis of a single clinical trial, and many other trials involved small groups of patients and shorter durations,” reports the Washington Post in its summary of the study, which appears in the January edition of The Journal of the American Medical Association.  “Only about 40 percent of approvals included trials in which the new drug was compared with existing drugs on the market.”
 
By comparison, there exists over 20,000 published studies or reviews in the scientific literature referencing the cannabis plant and its cannabinoids, nearly half of which were published within the last five years, according to a keyword search on PubMed Central, the government repository for peer-reviewed scientific research. Of these, more than 100 are controlled clinical trials assessing the therapeutic efficacy of cannabinoids for a variety of indications.
 
A 2006 review of 72 of these trials, conducted between the years 1975 and 2004, identifies ten distinct pathologies for which controlled studies on cannabinoids have been published. The review concludes that these trial data “affirm that cannabinoids exhibit an interesting therapeutic potential as antiemetics, appetite stimulants in debilitating diseases (cancer and AIDS), analgesics, as well as in the treatment of multiple sclerosis, spinal cord injuries, Tourette syndrome, epilepsy and glaucoma.”
 
A 2010 review of 37 additional controlled trials, conducted between the years 2005 and 2009, similarly acknowledges the plant’s efficacy, finding, “Based on the clinical results, cannabinoids present an interesting therapeutic potential mainly as analgesics in chronic neuropathic pain, appetite stimulants in debilitating diseases (cancer and AIDS), as well as in the treatment of multiple sclerosis.” The review estimates that some 6,100 patients suffering from a wide range of ailments have taken part in clinical cannabis trials over the past decades – a far greater cohort of subjects than would typically participate in clinical trials for more conventional therapeutics.
 
Most recently, a 2012 review of more recent clinical trials conducted by the California Center for Medicinal Research, involving several hundred patients, concluded emphatically: “Recent clinical trials with smoked and vaporized marijuana, as well as other botanical extracts, indicate the likelihood that the cannabinoids can be useful in the management of neuropathic pain, spasticity due to multiple sclerosis, and possibly other indications...Based on evidence currently available the Schedule I classification is not tenable; it is not accurate that cannabis has no medical value, or that information on safety is lacking.”
 
The bottom line: Scientists now know more about cannabis as a medicine than regulators know about many of the FDA-approved pharmaceuticals that the plant could replace.

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