The Clinton administration announced at a December 30 press conference that doctors who prescribe or recommend marijuana under voter-approved provisions in California and Arizona may face criminal prosecution under federal law and lose their ability to write prescriptions. Federal officials had threatened to take such action for months, but had not endorsed a formal strategy until Monday's press conference.
"The recent passage of propositions which make dangerous drugs more available in California and Arizona poses a threat to the National Drug Control Strategy goal of reducing drug abuse in the United States," stated Drug Czar Barry McCaffrey in a seven-page release outlining the administration's response to the initiatives. "These propositions are not about compassion, they are about legalizing dangerous drugs," he told reporters.
The administration's proposal states that the Drug Enforcement Administration (DEA) will revoke the federal registrations of physicians who recommend or prescribe marijuana according to the provisions of the newly enacted state laws. McCaffrey and Attorney General Janet Reno also stated that the Justice Department may criminally prosecute physicians who prescribe marijuana for use in treatment.
"I believe it's outrageous that the federal government is using taxpayer's money in this way, to go after honest doctors caring for very sick people," said Dr. Toni Brayer of the San Francisco Medical Society, which represents about 2,200 AIDS and cancer specialists in the bay area and backs California's medical marijuana measure. Brayer was one of many physicians nationwide who criticized the administration's strategy. She accused the administration of using "scare tactics to frighten legitimate doctors from using [marijuana] for very sick people."
Fellow San Francisco physician, Dr. Richard Cohen agreed. "The federal government is stepping in and literally intimidating ... a patient population that could be helped," he told reporters.
They can't go after the voters in California and Arizona, so they go after the medical profession," said Dr. David C. Lewis, director of the Center for Alcohol and Addictive Studies at Brown University. "Now the federal government is entering the practice of medicine, placing itself in the physician's office between the doctor and patient.
Congressman Barney Frank (D-Mass.) also announced his opposition to the Clinton-backed plan. "Medical practitioners who are following the dictates of their profession and the laws adopted by the voters of their states by prescribing the method they think best suited to reduce suffering in seriously ill people do not deserve to be persecuted by the federal government," said Frank, a longtime supporter of medical marijuana. Frank worked with NORML in 1995 to introduce federal legislation permitting physicians to prescribe marijuana as a therapeutic agent for seriously ill patients (H.R. 2618). "What we have here is an instance of the Federal Executive Branch... overturning the voters of two states, not because of some conflict with some Constitutional principle, but because the federal government disagrees with the citizen's policy choices."
NORML Executive Director, Attorney R. Keith Stroup elaborated on Frank's statements. "Although the state initiatives exempt medical patients from state criminal penalties prohibiting the cultivation and use of marijuana, Justice Department lawyers concede that there exists no solid constitutional grounds for attacking the initiatives in court. There is no requirement that each state adopt criminal penalty to mimic each and every federal drug law."
Stroup also questioned the administration's assurance that it "will continue to review claims about the possible [medical] benefit of smoked marijuana," noting that an FDA-approved protocol by San Francisco researcher Dr. Donald Abrams to examine marijuana's effect on the AIDS wasting syndrome has been stonewalled by the National Institute on Drug Abuse for four years. Recent plans to conduct a state-sponsored study at Washington State University to evaluate claims by cancer patients and others about the medical effectiveness of marijuana have also been delayed by federal officials, Stroup added. "Government officials are engaging in sophistry. On the one hand, they deny the existence of scientific studies conducted throughout the 1970's and 1980's indicating marijuana's medical utility and block new federal research, while on the other, they argue that the sick and dying should be denied an effective medication because there is not enough research."
Loren Siegel, director of public education for the American Civil Liberties Union (ACLU) agreed. Calling McCaffrey's remarks the "height of hypocrisy" in a released statement, Siegel noted that the federal "government has consistently impeded research into medical marijuana -- for political, not scientific reasons."
Another critical aspect of the controversial federal plan allows the DEA to "adopt" seizures of marijuana and other Schedule I controlled substances made by state and local law enforcement officials following an arrest where state and local prosecutors must decline prosecution because of the newly established state laws. Once in the possession of the DEA, the drugs can be destroyed and further criminal action may be pursued. However, federal officials admit that it is unlikely that the agency will prosecute small time offenders.
The administration also warned employees and contractors who received federal funds that individuals may not use the state provisions as an exemption to the requirements of the Federal Drug-Free Workplace program. "Medical Review Officers will not accept physician recommendations for Schedule I substances as a legitimate explanation for a positive drug test," the plan states.
In addition, the plan recommends that physicians who prescribe or recommend marijuana to patients be excluded from the Medicaid and Medicare programs.
The American Medical Association (AMA), one of the country's primary physician's groups, urged doctor's "to prescribe [only] effective, legal medications ... to compassionately treat disease and relieve pain" for now, and requested for "federal funding of research to determine the validity of marijuana as an effective medical treatment."
"The administration's actions this week effectively wreak havoc on not only states' rights and the will of the voters, but also on the First Amendment rights of doctors and the privileged relationship between a physician and his or her patient," summarized NORML Deputy Director Allen St. Pierre. "Patients who could benefit from marijuana's therapeutic value remain held hostage by a federal administration that appears more concerned about political rhetoric than the well being of the sick and dying."
For more information or a copy of the administration's seven-page strategy, please contact Allen St. Pierre or Paul Armentano of NORML at (202) 483-5500. For further information on medical marijuana, please contact either Dave Fratello of Americans for Medical Rights at (310) 394-2952 or Dale Gieringer of California NORML at (415) 563-5858. For information on the Arizona initiative, please contact Sam Vagenus of Arizonans for Drug Policy Reform at (602) 285-0468. Dr. Donald Abrams of UC-San Francisco may be contacted at (415)476-9554.