Medical Marijuana: Review and Analysis of Federal and State Policies

The issue before Congress is whether to continue the federal prosecution of medical marijuana patients and their providers, in accordance with marijuana's status as a Schedule I drug under the Controlled Substances Act, or whether to relax federal marijuana prohibition enough to permit the medical use of botanical cannabis products by seriously ill persons, especially in the states that have created medical marijuana programs under state law.

Bills have been introduced in recent Congresses to allow patients who appear to benefit from medical cannabis to use it in accordance with the various regulatory schemes that have been approved, since 1996, by the voters or legislatures of 11 states. In the current Congress, the States' Rights to Medical Marijuana Act (H.R. 2087/Frank) would move marijuana from Schedule I to Schedule II of the Controlled Substances Act and make it available under federal law for medical use in the states with medical marijuana programs. The Steve McWilliams Truth in Trials Act (H.R. 4272/Farr) would make it possible for defendants in federal court to reveal to juries that their marijuana activity was medically related and legal under state law.

In June 2005, the House defeated, for the third time, the Hinchey-Rohrabacher amendment to prevent federal enforcement of the Controlled Substances Act against medical marijuana patients in the states that have approved such use. The amendment is expected to be offered again in the 2nd session of the 109th Congress.

Eleven states, mostly in the West, have enacted laws allowing the use of marijuana for medical purposes, and many thousands of patients are seeking relief from a variety of serious illnesses by smoking marijuana or using other herbal cannabis preparations. Meanwhile, the federal Drug Enforcement Administration refuses to recognize these state laws and continues to investigate and arrest, under federal statute, medical marijuana providers in those states and elsewhere.

Claims and counterclaims about medical marijuana -- much debated by journalists and academics, policymakers at all levels of government, and interested citizens -- include the following: marijuana is harmful and has no medical value; marijuana effectively treats the symptoms of certain diseases; smoking is an improper route of drug administration; marijuana should be rescheduled to permit medical use; state medical marijuana laws send the wrong message and lead to increased illicit drug use; the medical marijuana movement undermines the war on drugs; patients should not be arrested for using medical marijuana; the federal government should allow the states to experiment and should not interfere with state medical marijuana programs; medical marijuana laws harm the federal drug approval process; the medical cannabis movement is a cynical ploy to legalize marijuana and other drugs. With strong opinions being expressed on all sides of these complex issues, the debate over medical marijuana does not appear to be approaching resolution.

This report will be updated as legislative activity and other developments occur.

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