“Failed experiment” continueD FRoM page 13 Prohibition of marijuana is a relatively patients would be using marijuana under the recent development. It was enacted by Congress guise of research—most states used a similar in 1937 over the objections of the American subterfuge—along with all kinds of regulation Medical Association. The bill contained an and bureaucracy that, as it turned out, kept the exception for medical use, but gradually the program from working well. The bill established feds leaned on the medical community—which “a program to research the therapeutic effects yielded—to stop using it as medicine, mainly of marihuana on certain patients; establishing then an analgesic. Subsequently, research demon- a board of review for the program; requiring strated additional uses for marijuana in treating ... regulations for the program; establishing maladies from glaucoma to cholera, though the requirements for admission in the program; United States—given its prohibition—was not authorizing the health division to contract to until recently on the cutting edge of that kind of receive marihuana.” (Until the Reagan adminresearch. Just this year, Science Direct published istration, the federal government perversely a paper by Chinese and New York scientists spelled marijuana’s name with an H, and state that found cannabis “can prevent acute alcohollegislatures had to follow suit.) Research in induced liver steatosis” in laboratory animals. marijuana had been stymied by the federal The climate of the 1970s was congenial government for decades. Soon more than 25 to Randall’s activism. Richard Nixon, who states put on their scientist caps and got in the launched his own drug war, was gone, though his business—though few scholarly papers resulted. legacy—increased drug use as a result of accelerIn something of a mockery of the serious ated enforcement of prohibition—lingered on. needs of patients, approval of the Nevada President Gerald Ford adopted a saner approach measure was fueled not just by the science to drugs, leaving a White House drug “czar” and the efficacy of the drug but by two politioffice created by Congress vacant. He deemcians who opposed marijuana until their own phasized enforcement in favor of treatment. He personal interests became engaged. Conservative was followed into the White House by Jimmy Democrat and state court judge Keith Hayes and Carter, who followed a conservative Republican similar softer policy until he and former state sena“Who, but a needed some political cover, tor James Slattery had whereupon Carter staffed the little use for the drug bureaucrat, drug office and got tough. until Hayes contracted Randall set about cancer and Slattery’s wife Would be dumb helping fellow glaucoma developed glaucoma. enough to give a patients, then victims “However, if it appeared of other maladies as to [be] medically approprivomiting patient he learned more about ate, I would consider marijuana’s wider value as smoking it, but it would be a pill?” a virtual wonder drug. He a cultural departure for me,” RobeRt Randall immersed himself in the Hayes told reporter Tricia Author/glaucoma patient issue of medical marijuana, White. He said his changed becoming something of a view was driven by the lay expert, producing half agony of chemotherapy. a dozen books like Muscle Spasm, Pain, and The two men became lobbyists for medical Marijuana Therapy (Galen Press, 1991). marijuana. Unfortunately, they were unsophisRandall joined a petition to the Drug ticated about it. At an April 27 hearing, asked Enforcement Administration for reclassification if the bill would allow pot smoking, Hayes told of marijuana. As in the case of his criminal trial, the legislators that the medicine used would he found that if someone could be coaxed into ideally be in tablet form, if such was available. examining the research with an open mind, the This was a notion federal drug warriors— verdict was assured. DEA administrative law desperate to block the spread of medical marijudge Francis Young spent two years holding juana—had been pushing, that THC (an active hearings and studying the research, then ruled ingredient in marijuana) could be made into a in 1988, “Marijuana in its natural form is one pill. Drug companies had no interest in distributof the safest therapeutically active substances ing it for the feds and approval through the Food known to man. ... Uncontroverted evidence in and Drug Administration moved slowly, but the this record indicates that marijuana was being big problem was that it didn’t work effectively. used therapeutically by mankind 2000 years It was eventually approved for several uses, before the Birth of Christ. … [T]he marijuana including nausea and vomiting of patients plant … has a currently accepted medical use undergoing chemotherapy. But its effect hit in the United States.” The DEA ignored it. the body with a jolt compared to the gradual Along the way, Randall was tireless. Early absorption of smoked marijuana that patients on, in the late 1970s and early ’80s, a number could control, a critical problem for an antiof states made medical use of marijuana legal. nausea drug. Randall was fond of saying, “Who, New Mexico was the first, in 1978, and Randall but a bureaucrat, would be dumb enough to was deeply involved, as he was in other states, give a vomiting patient a pill?” This was an either in person or on paper. He was like the anti-nausea medication that could cause nausea, Johnny Appleseed of medical marijuana. a neat match for that anti-glaucoma medicine Then the effort moved to Nevada. that had temporarily blinded Randall. Hayes was not speaking for informed patients but Silver State trial lawmakers were responsive to him (he had previously chaired Assembly Judiciary). The measure was Senate Bill 470 of the 1979 As it happened, at that same hearing where Nevada Legislature. No one was brave enough to Hayes spoke, a letter from Randall—who sponsor it, so it was given a committee introduccould not attend in person—was presented tion. To provide further political protection, to the committee, and it warned against 14 | RN&R | MARCH 13, 2014
Some of the books penned by Robert Randall.
exactly the technique Hayes promoted. “The only flaw in the [Nevada bill’s] approach is, I think, in the proposed legislation’s neglect of organic cannabis preparations in favor of synthetic marijuanalike substances,” Randall wrote. “I cannot emphasize enough the dangers which reliance on synthetic cannabis poses. … Delta-9-THC, the preparation of synthetic marijuana now available … is not marijuana’s most therapeutically active substance, but merely its most psycho-active. …Evidence suggests Delta-9-THC is effective in some cases. This is also true for both glaucoma control and as an anti-emetic. Yet the evidence also indicates that the oral preparations of Delta-9-THC are inferior to marijuana in smoked form. In a recent study conducted by the National Cancer Institute, 15 cancer chemotherapy patients were tested. Initially, all were placed on oral Delta-9THC. At the conclusion of the study, however, all patients had been transferred to smoked marijuana. In effect, Delta-9-THC became ineffective while the federally-developed, dose controlled cigarettes continued to offer relief.” Randall enclosed a Cancer Institute memo on the issue and also urged the lawmakers to protect patients from “the Hobson’s choice between medical relief and criminality.” The Nevada Medical Association, a Clark County prosecutor, and others endorsed the legislation. It was approved by both houses— both had Democratic majorities—and signed by Republican Gov. Robert List. The final legislation was silent on how the treatment was to be applied, by pill or joint, and it allowed the Nevada Board of Health to extend the program beyond cancer and glaucoma if it chose.
ObStacleS The program went into effect with a budget of less than $32,000, most of it for start-up costs
like new office furniture and travel to states with similar programs for planning purposes. No state workers were added and the program was housed in the already existing state Health Division. The program was swaddled in bureaucracy designed to further protect the legislators, with the result that patients were discouraged from using it. The process of qualifying for the program was complicated, so using traditional access to marijuana was simpler and faster—and pain or blindness doesn’t wait. Just as detrimental was the election of Ronald Reagan as president the year after the Nevada program was created. Since Virginia City enacted the nation’s first anti-drug law in 1876 as a result of racism, bad journalism, and political exclusion of health professionals, manufacturing anti-drug hysterias had become a United States tradition, and in the 20th century evolving public relations techniques took those panics national. The Hearst press and federal official Harry Anslinger—the J. Edgar Hoover of drug prohibition—had been the biggest ringmasters, but in the second half of the century, presidents launched scares—first Lyndon Johnson, who had moderate success; then Richard Nixon, who popularized the term “war on drugs”; then Reagan; and finally the first George Bush. The result was that each time drug scares died down and more sensible policies came to the fore, another hysteria was launched, and the real experts were driven into the background. Initially, after Reagan took office, the spread of medical marijuana continued—more than 30 states were on board. But the notion that Reagan was as benign on drugs as Ford and Carter ended on Oct. 2, 1982. The skills of his handlers in manipulating public opinion created the most damaging hysteria to date. A month