Gordon Farrell Ethridge

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doctor or arrest the person and let the courts decide.

It should be no more confusing than determining if someone drinking alcohol is underage or on probation, if someone is the legal owner of a piece of property, or if a person is a legal immigrant or not.

Response B: [Use the GAO statement in the response to Challenge #17.]

CHALLENGE #21: "Cannabis buyers' clubs are totally out of control!"

Response A: Many dispensaries or buyers' clubs in California (the only state whose law currently allows for such entities) have now worked out cooperative arrangements with local law enforcement and public health officials. Former San Francisco District Attorney Terence Hallinan explained:

"Our Department of Public Health has established a system of identification cards that protects patient confidentiality while helping law enforcement identify documented medical marijuana patients. Nonprofit medical marijuana dispensaries have become an important part of this system, providing a safe, quality-controlled supply of medicinal cannabis to seriously ill people and working closely with local law enforcement and public health officials."31

Response B: Many cities have developed or are in the process of developing regulations to ensure that medical marijuana dispensaries operate in a safe, healthful, and law-abiding manner. State and local officials have the ability to prosecute dispensary operators who do not obey the law. "Out of control" clubs will be shut down, and the operators will serve serious time in prison. The biggest obstacle to effective local regulation of dispensaries is federal law that irrationally treats anyone providing medical marijuana to a cancer or AIDS patient as a common drug dealer. States and cities will have no trouble effectively regulating dispensaries if the federal government will let them.

Response C: Any problems with dispensaries could be eliminated if Congress passed federal legislation allowing states to create a system whereby medical marijuana is sold through licensed pharmacies. Such a system is already in place in the Netherlands and Canada.

CHALLENGE #22: "Isn't the medical marijuana issue just a sneaky step toward legalization?"

Response A: How? Exactly how does allowing seriously ill patients to use marijuana lead to the end of the prohibition of marijuana for recreational use? Doctors are allowed to prescribe cocaine and morphine, and these drugs are not even close to becoming legal for recreational use.

Response B: Each law should be judged on its own merits. Should seriously ill patients be subject to arrest and imprisonment for using marijuana with their doctors' approval?

If not, then support medical marijuana access. Should healthy people be sent to prison for using marijuana for fun? If so, then keep all non-medical uses illegal. There's no magic tunnel between the two.

Response C: Supporters of medical marijuana include some of the most respected medical journals and public-health organizations, including the American Academy of Family Physicians, American Public Health Association, American Nurses Association, American Academy of HIV Medicine, and the state medical societies of New York, California, and Rhode Island. Do you really think these organizations are part of a conspiracy to legalize drugs?

CHALLENGE #23: "Are people really arrested for medical marijuana?"

Response A: There were dozens of known medical marijuana users arrested in California in the 1990s, which is what prompted people to launch the medical marijuana initiative there. There have been many other publicized and not-so-publicized cases across the United States. Even after Proposition 215 passed in November 1996, the federal government has continued to raid, arrest, and jail medical marijuana patients and caregivers. (See also Response B to Challenge #24.)

Response B: Nearly 16 million marijuana users have been arrested since 1970.32 Unfortunately, the government does not keep track of how many were medical users. However, even if only 1% of those arrestees used marijuana for medical purposes, that is nearly 160,000 patients arrested!

Response C: You insist that patients don't really get arrested for using medical marijuana. If that is the case, then the bill/ initiative doesn't change anything. Why are you so strongly opposed to it?

Response D: The possibility of arrest is itself a terrible punishment for seriously ill patients. Imagine the stress of knowing that you can be arrested and taken to jail at any moment. Stress and anxiety are proven detriments to health and the immune system. Should patients have to jump out of bed every time they hear a bump in the night, worrying that the police are finally coming to take them away?

CHALLENGE #24: "Do people really go to prison for medical marijuana offenses?"

Response A: Federal law and the laws of 38 states do not make any exceptions for medical marijuana. Federally, possession of even one marijuana cigarette carries a penalty of up to one year in prison. Cultivation of even one plant is a felony, with a maximum sentence of five years. Most states' laws are in this same ballpark. With no medical necessity defense available, medical marijuana users are treated the same as recreational users. Many are sent to prison.

Response B: There are too many examples to list. Here are just a few: Rancher and Vietnam veteran Larry Rathbun was arrested in December 1999 for cultivating medical marijuana to relieve his degenerative multiple sclerosis. When he was

arrested in 1999, he could still walk, which he attributes to the medical use of marijuana. After serving 19 months, Rathbun came out of Montana State Prison confined to a wheelchair. Byron Stamate spent three months in a California jail for growing marijuana for his disabled girlfriend (who killed herself so that she would not have to testify against Byron). Gordon Farrell Ethridge spent 60 days in an Oregon jail for growing marijuana to treat the pain from his terminal cancer. Oklahoman Will Foster served over four years in prison (of an original sentence of 93 years) for growing marijuana for chronic pain. Quadriplegic Jonathan Magbie, who used marijuana to ease the constant pain from the childhood injury that left him paralyzed, died in a Washington, D.C., jail in September 2004 while serving a 10-day sentence for marijuana possession.

Response C: Estimates vary, but all sources agree that there are at minimum tens of thousands of marijuana offenders in prisons and jails at any given time. Even if only 1% of them are medical marijuana users, that is hundreds of patients behind bars right now!

Response D: Even if a patient is not sent to prison, consider the trauma of the arrest. A door kicked in, a house ransacked by police, a patient handcuffed and put into a police car. Perhaps a night or two in jail. Court costs and attorney fees paid by the patient and the taxpayers. Probation—which means urine tests for a couple of years, which means that the patient must go without his or her medical marijuana. Huge fines and possible loss of employment—which hurt the patient's ability to pay insurance, medical bills, rent, food bills, home-care expenses, and so on. Then there's the stigma of being a "druggie." Doctors might be too afraid to prescribe pain medication to someone whom the system considers a "drug addict." Should any of this happen to seriously ill people for using what they and their doctors believe is a beneficial medicine?

CHALLENGE #25: "Isn't the government making it easier to do medical marijuana research? Since they are becoming more flexible, shouldn't we wait for that research before we proceed?"

Response A: As a Schedule I drug, marijuana can be researched as a medicine only with federal approval. Until California voters passed Proposition 215 in 1996, federal authorities blocked all efforts to study marijuana's medical benefits. Since then, federal restrictions have been loosened somewhat, and a small number of studies have gone forward, but that happened because the passage of ballot initiatives forced the government to acknowledge the need for research. The federal government remains intensely hostile to medical marijuana, and if the political pressure created by ballot initiatives and legislative proposals subsides, the feds will surely go back to their old, obstructionist ways. The federal government has been supplying medical marijuana to a small group of patients for over 20 years, but has refused to study even its own patients!

Response B: The studies approved by the federal government thus far are small, pilot studies that will provide useful data, but are not large enough to bring about FDA approval of marijuana as a prescription drug. And all medical marijuana research must be done with marijuana supplied by the National Institute on Drug Abuse. NIDA's product is poor-quality, low-grade marijuana that is likely to show less efficacy and greater side effects than the marijuana available through medical marijuana dispensaries in California and elsewhere — but it remains illegal to use this higher-quality marijuana for research! Scientists and activists have appealed to the Drug Enforcement Administration to allow other sources of marijuana to be used, but such efforts — including a recent proposal from the University of Massachusetts — have repeatedly been blocked by the federal government. The U.S. government remains the largest single obstacle to medical marijuana research.

Response C: Although research is beginning to move forward, it will take time. Should seriously ill patients have to risk arrest and jail in the meantime, for using a medicine that they and their doctors find beneficial?

CHALLENGE #26: "You can't control the dosage of a crude plant product."

Response A: Marijuana is so safe that patients can easily find the proper dose themselves with no danger of overdose. As University of Washington researcher Dr. Gregory Carter and colleagues noted in a recent journal article, "THC (and other cannabinoids) has relatively low toxicity and lethal doses in humans have not been described ... It has been estimated that approximately 628 kilograms of cannabis would have to be smoked in 15 minutes to induce a lethal effect."

Response B: In his book, Understanding Marijuana, University of Southern California psychology professor Mitch Earleywine explains, "Smoked marijuana may also have fewer side effects than oral THC and other drugs. Patients can smoke a small amount, notice effects in a few minutes, and alter their dosages to keep adverse reactions to a minimum."

Response C: The Canadian government-approved prescribing information for Sativex, the natural marijuana extract now sold by prescription in Canada (discussed in Challenge #6), gives patients complete freedom to adjust their dose as needed. The official pamphlet provided to patients specifies: "The dose you require is determined by you. You can determine the dose that best suits you according to the pain relief you experience."35 Patients using whole marijuana can do just the same — and more easily, because the action of vaporized or smoked marijuana is much faster than Sativex.

CHALLENGE #27: "How can you call something a medicine when you have to smoke it? Smoke is not a medicine, and marijuana smoke contains more carcinogens than tobacco smoke."

Response A: Patients don't need to smoke marijuana. Marijuana can be vaporized, eaten, or made into extracts and

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