The US government's longstanding denial of medical marijuana research and use is an irrational and morally bankrupt public policy. On this point, few Americans disagree. As for the question of "why" federal officials maintain this inflexible and inhumane policy, well that's another story.
This fact was evident in the varied responses I received following my most recent Huffington Post essay, "What Your Government Knows About Cannabis And Cancer -- And Isn't Telling You." Several readers wrote me asserting that the Feds' seemingly inexplicable ban on medical pot -- and the use of cannabis by adults in general -- is because neither the US government nor the pharmaceutical industry can patent it or profit from it. A related, yet equally common hypothesis argues: Big Pharma lobbies the federal government to keep pot illegal because it won't be able to compete with patients growing their own medicine.
They're appealing theories, yet I've found neither to be accurate nor persuasive. Here's why.
Mass Marketing Medical Pot
First, let me state the obvious. Big Pharma is busily applying for -- and has already received -- multiple patents for the medical properties of pot. (The US government has too, but that's a different story all together.) These include patents for synthetic pot derivatives (such as the oral THC pill Marinol), cannabinoid agonists (synthetic agents that bind to the brain's endocannabinoid receptors) like HU-210 and cannabis antagonists such as Rimonabant. This trend was most recently summarized in the National Institutes of Health paper, "The endocannabinoid system as an emerging target of pharmacotherapy," which concluded, "The growing interest in the underlying science has been matched by a growth in the number of cannabinoid drugs in pharmaceutical development from two in 1995 to 27 in 2004."
In other words, at the same time the American Medical Association and federal lawmakers are proclaiming that pot has no established medical value, Big Pharma is in a frenzy to bring dozens of new, cannabis-based medicines to market.
Not all of these medicines will be synthetic pills either. Most notably, GW Pharmaceutical's oral marijuana spray, Sativex, is a patented standardized dose of natural cannabis extracts. (The extracts, primarily THC and the non-psychoactive, anxiolytic compound CBD, are taken directly from marijuana plants grown at an undisclosed, company warehouse.)
Does Big Pharma's sudden and growing interest in the research and development of pot-based medicines mean that the industry is proactively supporting marijuana prohibition? Not if they know what's good for them.
First, any and all cannabis-based medicines must be granted approval from federal regulatory bodies such as the US Food and Drug Administration -- a process that remains as much based on politics as it is on scientific merit. Chances are that a government that is unreasonably hostile toward the marijuana plant will also be unreasonably hostile toward sanctioning cannabis-based pharmaceuticals.
A recent example of this may be found in the Medicine and Health Products Regulatory Agency's recent denial of Sativex as a prescription drug in the United Kingdom. (Sativex's parent company, GW Pharmaceuticals, is based in London.) In recent years, British politicians have taken an atypically hard-line against the recreational use of marijuana -- culminating in Prime Minister Gordon Brown's declaration that today's pot is now of "lethal quality." (Shortly thereafter, Parliament elected to stiffen criminal penalties on the possession of the drug from a verbal warning to up to five years in jail.)
In such an environment is it any wonder that British regulators have steadfastly refused to legalize a pot-based medicine, even one with an impeccable safety record like Sativex? Conversely, Canadian health regulators -- who take a much more liberal view toward the use of natural cannabis and oversee its distribution to authorized patients -- recently approved Sativex as a prescription drug.
Targeting the Consumer
Of course, gaining regulatory approval is only half the battle. The real hurdle for Big Pharma is finding customers for its product. Here again, a culture that is familiar with and educated to the use therapeutic cannabis is likely going to be far more open to the use of pot-based medicines than a population still stuck in the grip of "Reefer Madness." (For example, Marinol, despite having been approved by the FDA in 1986, was rescheduled so that doctors might prescribe it more liberally in 1999 -- three years after California and other states began approving medical marijuana use legislation. Coincidence? I doubt it.)
Will those patients who already have first-hand experience with the use of medical pot switch to a cannabis-based pharmaceutical if one becomes legally available? Maybe not, but these individuals comprise only a fraction of the US population. Certainly many others will -- including many older patients who would never the desire to try or the access to obtain natural cannabis. Bottom line: regardless of whether pot is legal or not, cannabis-based pharmaceuticals will no doubt have a broad appeal.
That said, many argue that the legal availability of pot would encourage patients to use fewer pharmaceuticals overall and significantly undercut Big Pharma's profits. To a minor degree this may be a possibility, though likely not to an extent that adversely impacts the industry's bottom line. Certainly most individuals in the Netherlands, Canada, and in California -- three regions where medical pot is both legal and easily accessible on the open market -- use prescription drugs, not cannabis, for their ailments. Further, despite the availability of numerous legal healing herbs and traditional medicines such as Echinacea, Witch Hazel, and Eastern hemlock most Americans continue to turn to pharmaceutical preparations as their remedies of choice.
Should the advent of legal, alternative pot-based medicines ever warrant or justify the criminalization of patients who find superior relief from natural cannabis? Certainly not. But, as the private sector continues to move forward with research into the safety and efficacy of marijuana-based pharmaceuticals, it will become harder and harder for the government and law enforcement to maintain their absurd and illogical policy of total pot prohibition.
Needless to say, were it not for advocates having worked for four decades to legalize medical cannabis, it's unlikely that anyone -- most especially the pharmaceutical industry -- would be turning their attention toward the development and marketing of cannabis-based therapeutics. That said, I won't be holding my breath waiting for any royalty checks.
If Not Big Pharma, Then Who?
So, if Big Pharma isn't a significant player in the ongoing prohibition of the personal use of cannabis, then who is responsible? Based on my experience, the answer is obvious. First and most importantly, there's federal government -- as represented not only by the lawmakers who continue to vote in favor of America's Draconian drug policies, but also the numerous acronymn ladened bureaucracies (such as the ONDCP, NIDA, etc.) who actively lobby against any change in direction.
The second most powerful player in maintaining pot prohibition? That's easy: law enforcement, as represented by bigwigs like the US Drug Enforcement Administration and the California Narcotics Officers Association, all the way down the line to small-town police forces -- all of whom consistently finance efforts to derail any relaxation of federal, state, or local marijuana policies.
The third and final primary player responsible for maintaining modern-day pot prohibition? Unfortunately, that would be us, the general public -- a majority of whom have repeatedly voiced disapproval for legalizing the use personal use of pot by adults in both national polls and on statewide ballot initiatives, most recently in Colorado and in Nevada in 2006. (By contrast, more than half of Americans do support -- and have consistently voted for -- legislation in support of the qualified medical use of cannabis by authorized patients.)
In short, until there is a significant sea-change in the attitudes and actions of the Feds, cops, and the general public, expect prohibition -- particularly the broader prohibition on the recreational use of cannabis -- to continue.