State marijuana initiatives open
new fronts in debate over illegal drugs

In this story:

• 'It's a national issue now'
• New action widens the argument
• A toke'n'cure?
• Scientific study requested
• Related stories and sites

(CNN) -- The battle over drugs in America shifted radically on November 5, 1996, when California and Arizona approved using marijuana for medical purposes.

The passing of California's Proposition 215 and Arizona's Proposition 200 represents a watershed in the American approach toward the use of drugs. In the case of Arizona, voters even went beyond marijuana, approving the medical use of drugs such as heroin and LSD.

It was a shift from a united federal and state front against illicit drugs to one where some states are now at odds with the federal government over the medical use of illegal substances. The policy issue has become: Who controls America's laws on drugs -- the federal government or state voters?

The legalization of marijuana raises other broad questions for both sides: Would it undermine the seemingly endless federal war on drugs by moving towards greater tolerance of marijuana and other drugs? Is more research needed to determine the benefits or hazardous effects of marijuana? Would it open the door to legalization of other controlled substances? And does pot really make good medicine?

Like many political controversies, this issue, too, is headed for the courts. After the initiative passed, America's so-called drug czar, retired four-star general Barry McCaffrey, publicly warned doctors not to break federal law by prescribing marijuana. Soon after McCaffrey's warning, a group of California physicians filed suit claiming that their rights to advise their patients were being trampled on.

The federal government is vehemently opposed to any loosening of laws governing Schedule I drugs, which include marijuana, heroin and synthetic designer drugs. Opponents of the new medical marijuana legislation decry it as a back-door attempt to legalize all drugs.

"The president thinks it's time for an offensive in the war on drugs and not a time for surrender," said White House press secretary Mike McCurry. He made his comments in February 1996, when arch-conservative William F. Buckley and his magazine National Review endorsed legalization of drugs in some form.

McCaffrey says drug legalization is now on the table.

"It's a national issue now. It's not just a California or an Arizona issue," he said. "We know that these proponents of drug legalization are promoting it in other states."

Indeed, the movement is afoot across the land with new vigor. Efforts to put medical marijuana laws on the books are under way in several states.

Massachusetts was the first state to follow in the footsteps California and Arizona after their referenda passed. The state's Department of Public Health has issued new rules that allow people with doctor-certified conditions to avoid state prosecution. But the new rules do not legalize pot or give doctors the authority to prescribe the drug.

"We're trying to alleviate suffering and pain," said Massachusetts Public Health Commissioner David Mulligan. "In no sense are we encouraging marijuana use by the public."

In fact, a number of states decriminalized the possession of marijuana for certain medical cases long before the California and Arizona initiatives. Louisiana has passed such a measure three times since 1981, most recently in 1991, and Virginia has had a similar one on the books since 1979. More recently, 1994 saw Ohio give medical marijuana a thumbs up, though the legislature is now attempting an about-face on the subject.

But what makes the California and Arizona laws so different from their antecedents and many of their possible national offspring is their breadth.

The California law is written so that almost any pain or ailment could be construed as justification for the use of marijuana. Proposition 215 also allows the cultivation of marijuana, not just the possession.

Arizona slayed the sacred cow of narcotics. Proposition 200 goes beyond marijuana, often viewed as a soft drug by both sides, and empowers doctors to prescribe narcotics such as heroin if they see fit.

It is this broad nature of the initiatives that has drug legalization opponents up in arms.

"The proposition, by extension, also allows individuals to smoke and cultivate marijuana openly, on the premise that marijuana has been recommended for the individual's 'medical condition,'" said DEA Administrator Thomas A. Constantine.

Proponents of the initiatives agree legal clarification is needed, and California lawmakers are preparing to introduce clarifications in the legislature in January.

But all the brouhaha tends to muddy the crucial question: does pot makes for good medicine?

While some doctors suggest that marijuana has modest value as medicine, McCaffrey says "there is no convincing scientific evidence" that marijuana offers benefits that a patient can't get from approved prescription drugs. But in patients undergoing cancer chemotherapy or suffering from multiple sclerosis report fewer side-effects with marijuana than with regular drugs.

The American Medical Association and other official medical groups oppose medical marijuana, but a 1991 survey found 44 percent of cancer doctors had suggested use of marijuana to treat nausea associated with chemotherapy.

Still, a bulk of the marijuana as medicine case rests on individual testimonials. Before marijuana can be approved as a prescription drug, clinical trials to gauge its therapeutic effect on pain are needed. Federal policy has long discouraged such research, but the drug-control office is now pledging that "any serious" marijuana research request will be considered.

Political observers in both Arizona and California say approval of the two initiatives will likely set off more scientific studies on the effects of marijuana use for various diseases.

The White House has asked the Independent Institute of Medicine to undertake a study into marijuana's medical value. The study, which would cost about $1 million and take some 18 months to complete, would also focus on whether smoked marijuana is a possible therapy for conditions like AIDS and cancer.

Whatever its conclusions, the study is not likely to end the flap over the medical use of marijuana, but it will add an element of science to what has become an increasingly emotional and political debate.

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