Marijuana and Society

Abstract

Since the 1990s, the use of marijuana (cannabis) for medicinal and recreational purposes has received increasing attention. Marijuana's active ingredients belong to a class of compounds called cannabinoids. Cannabinoids have been used to treat insomnia, premenstrual syndrome, nausea, appetite loss, and motor disturbances associated with multiple sclerosis, in addition to other conditions. Marijuana's medicinal and recreational use is legal in a number of US states despite federal law, which has strict limitations regarding marijuana, including its use in biomedical research. With the spread of medical marijuana use, support for marijuana for recreational purposes has also grown, with several states legalizing such use and others decriminalizing it to some degree.

Overview

Marijuana has been cultivated in the Americas since the early seventeenth century when settlers brought it to Jamestown, Virginia, to produce hemp (a fiber product derived from the Cannabis plant). The plant was also recognized at that time for its medicinal purposes as an analgesic, antispasmodic, and sedative. An entry on marijuana can be found in an 1850 Pharmacopeia published in the United States. The medicinal use of marijuana, however, declined with the development of aspirin as well as morphine and other opium-derived drugs.

In the early twentieth century, social reform movements tried to eradicate the use of marijuana, along with alcohol, morphine, opium, and other drugs. At that time, local and state jurisdictions enacted laws that restricted the nonmedical use of marijuana or banned it altogether. Massachusetts was the first state to outlaw marijuana in 1911. In 1930, Congress created the Federal Bureau of Narcotics and appointed the first commissioner, Harry Jacob Anslinger. Anslinger believed that marijuana caused insanity and pushed users toward horrendous acts of criminality. In 1933, William Randolph Hearst began to denounce marijuana as well. Hearst owned more than twenty-eight newspapers, which began to publish stories about a link between violent acts and marijuana use.

Increasing Criminalization. In 1936, the Federal Bureau of Narcotics began to urge federal control over marijuana as it claimed it caused dire mental and moral changes among users. An infamous film titled Reefer Madness was released in the late 1930s, illustrating the purported effects of smoking marijuana. Originally financed by a small church group, it depicted a group of dealers whose actions get a lot of people killed, sexually assaulted, and committed to lunatic asylums. (The film ultimately became a cult phenomenon.) In 1937, Congress passed the Marijuana Tax Act, which levied a fee on commercial transactions involving the marijuana plant. By that time, however, every state had laws in place that made the possession or sale of marijuana illegal.

In 1951, Congress established mandatory minimum sentences for drug crimes under the Boggs Act. The Boggs Act imposed two- to five-year minimum sentences for first offenses, including simple possession, for drug users and traffickers. At that time, there was a belief that drug addiction was contagious and maybe even incurable. In 1956, Congress included marijuana in the Narcotics Control Act. This provided for stricter mandatory minimum sentences of two to ten years and fines of up to $20,000. Then, in 1968, President Lyndon Johnson created the Bureau of Narcotics and Dangerous Drugs (BNDD), partly in response to the dramatic increase in the use of marijuana and other drugs in the late 1960s. At the federal level, marijuana could still be used medicinally until 1970. It was at that time the federal government created the Comprehensive Drug Abuse Prevention and Control Act (now known as the Federal Controlled Substance Act). All controlled substances were classified into five schedules. The schedules were designed to provide a framework regarding the potential for abuse, medical use, and health consequences. Marijuana became a Schedule I controlled substance, which made it illegal for physicians to prescribe it.

In 1973, the BNND and the Office of Drug Abuse Law Enforcement (ODALE) merged to form the US Drug Enforcement Agency (DEA). Three years later, a federal court ruled in favor of a Washington, DC, man, Robert C. Randall, who used the Common Law Doctrine of Necessity to defend himself against charges he had cultivated marijuana, which he used to treat his glaucoma. Federal Judge James Washington referred to Randall's marijuana use as a medical necessity. After this, federal agencies responded to petitions filed by Randall by providing him with FDA-approved medical marijuana. Randall was the first American to receive marijuana for the treatment of a medical disorder.

In 1978, New Mexico passed the first state law that recognized the medical value of marijuana. Two years later, the National Cancer Institute began experimental use of an oral synthetic form of tetrohydrocannibinol, commonly known as THC, (the primary active ingredient in marijuana) called Marinol. At the same time, studies in six states compared smoked marijuana to Marinol in cancer patients who had not responded to traditional anti-vomiting medications. State experiments found that smoking marijuana was more effective, while the National Cancer Institute found only some patients responded to Marinol. The government, however, gave Marinol FDA approval while ignoring the results for smoked marijuana.

Scientists discovered cannabinoid receptors in the brain in 1990. The discovery led to a better understanding of how marijuana is medically effective when THC binds with the receptors. Despite this discovery, in 1991, the federal government suspended medical marijuana research because it went against George H. W. Bush administration's policy on the use of illegal drugs. A small number of patients were allowed to continue receiving marijuana, but new applicants were told to try synthetic forms of THC. At that point, only thirteen patients had received medical marijuana from the government. The applications of twenty-seven patients who had received approval were canceled. The chief of the Public Health Service stated he had fears that the number of applicants for medical marijuana could increase because of the AIDS epidemic.

The Push for Medical Marijuana Legalization. Possibly in response to the federal government's decision to end its medical marijuana program, the city and county of San Francisco introduced Proposition P on November 5, 1991. The ballot measure passed with 79 percent of the vote. The measure called for the restoration of marijuana preparations to the list of available medicines in California and the elimination of penalties for physicians who prescribed those preparations. Two years later, the American Medical Student Association (AMSA) unanimously endorsed rescheduling marijuana and called on US Attorney General Janet Reno to do so. The AMSA also passed a resolution asking President Bill Clinton to reopen the federal government's medical marijuana program.

California was the first state to loosen restrictions on growing, distributing, and using marijuana. Proposition 215, introduced in 1996, was a ballot measure to protect patients and physicians from state prosecution. California's legislature passed laws in 1994 and 1995 that recognized the medicinal use of marijuana, but Governor Pete Wilson vetoed both measures despite strong public support. A longtime activist, Dennis Peron, then pushed to have marijuana legalized through a direct vote by California's citizens in the 1996 elections. To get the measure on the ballot, Peron had to gather 433,000 signatures. He organized a political action committee (PAC) with his allies and called it Californians for Compassionate Use. They wrote the initiative and named it the Compassionate Use Act, which passed on November 5, 1996, with 56 percent of the vote. It made California the first state to develop a legal framework for medical marijuana.

Legalization Spreads. Alaska, Oregon, and Washington legalized medical marijuana in November 1998. Maine became the fifth state to legalize medical marijuana in 1999. The initiative passed with a 61 percent vote. Maine's law provided for a simple defense, meaning the state has the burden to prove that a patient's possession or medical use was not authorized by statute. Eight months later, Hawaii became the sixth state to legalize medical marijuana. Hawaii enacted a law rather than requiring a vote by registered voters for its passage.

Colorado and Nevada legalized medical marijuana in 2000. Early in 2004, Vermont legalized medical marijuana when Governor James Douglas allowed An Act Relating to Marijuana Use by Persons with Severe Illness to become law without his signature. Later that year, Montana became the tenth state to legalize medical marijuana. Rhode Island became the eleventh state to legalize medical marijuana in January 2006 when its legislature overrode the governor's veto. Less than a year later, New Mexico became the twelfth state to legalize medical marijuana, followed by Michigan (2008), New Jersey (2010), Washington, DC (2010), and Arizona (2010). Arizona's voters passed the law by a slim margin (4,341 of more than 1.5 million votes cast), while South Dakota voters declined to legalize medical marijuana. The following year, Delaware became the sixteenth state to legalize, and in 2012 Connecticut became the seventeenth. A month later, Massachusetts also legalized medical marijuana. In July 2013, despite the US Court of Appeal's ruling supporting marijuana's Schedule I status, New Hampshire legalized medical marijuana, but it also created an advisory council that would be required in five years to issue a formal opinion on whether marijuana should continue to be medically legalized. The next month, Illinois became the twentieth state to legalize it.

In April and May 2014, Maryland and Minnesota became the twenty-first and twenty-second states to legalize medical marijuana. The Minnesota law allowed only for oil, pill, and vaporized forms of medical marijuana, however. It prohibited smoking marijuana. In July 2014, New York legalized medical marijuana. The bill also prohibited smoked marijuana and provided for a medical marijuana tax of 7 percent. In 2016, Arkansas, Florida, North Dakota, Ohio, and Pennsylvania passed either ballot measures or senate or house bills to legalize medical marijuana in their states. West Virginia followed suit in 2017, as did Oklahoma, Missouri, and Utah in 2018 (Speights, 2020; Berke & Gould, 2020). South Dakota and Virginia approved medical marijuana in 2020 (Mississippi voters also supported a ballot measure on the issue, but it was overturned by the state supreme court). In 2021, Alabama became the thirty-sixth state to allow medical marijuana (Hartman, 2021). Medicinal marijuana is also approved in the U.S. territory of Guam (Guam DPHSS, 2022).

Federal Response. Two months after the passage of California's Proposition 215, the Clinton administration took aim at the new law, declaring that federal law was not affected by the state initiative. At the same time, Attorney General Janet Reno announced she was reallocating federal enforcement resources to target any California physicians who recommended marijuana to their patients. She also threatened to revoke those doctors' registration with the DEA and prohibit them from providing services in Medicare and Medicaid programs.

Shortly after the Clinton administration's response, a group of physicians, patients, and nonprofits filed a complaint to block the federal government from punishing physicians who recommended marijuana to their patients. The issue was settled when the US District Court of Northern California ruled to limit the ability of federal officials to punish physicians, citing the guidelines for Proposition 215 in support of their position.

On May 14, 2001, the US Supreme Court ruled in an 8–0 decision that there is no medical necessity exception to the Controlled Substances Act's prohibition on manufacturing and distributing marijuana. Additionally, in September 2002, a Washington, DC, court blocked a medical marijuana initiative from making it to the ballot. This was the second time medical marijuana use had been blocked in the capital. The first measure voters approved with a 69 percent majority vote, but Congress prevented the law from going into effect. Further, in 2003, the US House of Representatives also blocked an amendment that would have stopped federal raids on medical marijuana patients.

Despite the growing number of states approving medical marijuana, in 2005, the Supreme Court ruled that under the Controlled Substance Act, federal law enforcement officials had the right to punish anyone who dispensed, possessed, or used marijuana, regardless of state laws. The justices supported their decision by citing the commerce clause, which gives Congress the power to regulate interstate commerce, and saying that marijuana had potential for trade on the illicit market. The justices did not address the conflict between state and federal law.

In February 2009, it appeared the federal administration, under President Barack Obama, was beginning to soften its position on medical marijuana. US Attorney General Eric Holder stated that raids on medical marijuana clinics would cease. Later that same year, Holder also announced that the Department of Justice would not prioritize the prosecution of medical marijuana patients. The Department of Justice was discouraged from prosecuting individuals who were in compliance with their state laws with regard to their medical marijuana use, possession, or cultivation and their caregivers. The memo did emphasize that the prosecution of commercial enterprises that unlawfully sell marijuana for profit would continue to be an enforcement priority.

In July 2010, the US Department of Veterans Affairs decided to no longer disqualify medical marijuana users from several of its clinical programs, including substance abuse and pain control programs. During the months of March, April, and May, however, the US Department of Justice sent letters to officials in Arizona, Colorado, Montana, Rhode Island, Vermont, Hawaii, New Hampshire, Maine, and Washington threatening to prosecute those that implemented cultivation and distribution programs. Two months later, the DEA denied another request to reclassify marijuana from the Schedule I category. The DEA again stated that marijuana had no accepted medical use. In December 2010, the governors of Washington and Rhode Island petitioned the DEA again to reclassify marijuana as a Schedule II substance.

By January 2013, the US Court of Appeals had ruled that the federal government could classify marijuana as a Schedule I substance because there were no adequate and well-controlled studies on the medical efficacy of marijuana. After New Hampshire and Illinois proceeded to legalize medical marijuana, the US Department of Justice announced it would not challenge any of the states that had passed medical marijuana laws. In December 2016, shortly after several states had passed laws to legalize the medicinal and recreational use of marijuana, the DEA released a notice clarifying that all marijuana extracts, such as cannabidiol (CBD), remained Schedule I drugs, making all forms of marijuana illegal under US federal law.

The federal response to state marijuana legislation shifted after President Obama was succeeded by Donald Trump, who took up many socially conservative positions. In 2018, Trump's then-attorney general Jeff Sessions announced many Obama-era policy guidelines would be rescinded, including the memo discouraging prosecution of medical marijuana patients. (On the other hand, the 2018 Farm Bill removed hemp and other cannabis products containing less than 0.3 percent THC from the controlled substances list.) After the US House of Representatives came under Democratic Party control following the 2018 midterm election, there was considerable support for various bills regarding marijuana, including to protect the growing cannabis industry and even establish federal-level decriminalization. However, such legislation often continued to be blocked in the Senate.

Growing Acceptance of Recreational Use. In 2012 Colorado and Washington became the first states to legalize the recreational use of marijuana. After decriminalizing medical marijuana use in 2000, Colorado experienced a burst of entrepreneurial spirit from people eager to supply more than a million new medical marijuana card holders, and the number of marijuana shops in the Denver area grew steadily. (The legitimate need of many cardholders, 94 percent of whom claimed to suffer from chronic severe pain, was doubted by some critics.) In 2010, the legislature passed two bills clarifying rules and directing policy for the growth, distribution, and sale of marijuana. With a successful distribution system in place, expansion of the market to include recreational users became the next step for marijuana advocates. A strong legalization campaign targeted libertarians and others most likely to disapprove of the "war on drugs" and the negative consequences of criminalization. The ballot initiative Regulate Marijuana Like Alcohol Act of 2012, or Amendment 64, passed with 55 percent of Colorado's voters in favor. It allowed the limited use of the use and possession of marijuana by adults at least twenty-one years old, directly challenging federal law. Washington's voters passed a similar initiative soon after.

Alaska and Oregon passed similar laws in 2014, which took effect the following year. The District of Columbia also legalized recreational marijuana in 2014; a congressional rider prevented the District from allowing marijuana sales, but it became legal to possess, gift, grow, and use marijuana for recreational purposes in Washington, DC. In 2016, California, Nevada, Maine, and Massachusetts legalized the recreational use of marijuana via ballot initiatives. Michigan passed its own such ballot initiative in 2018. Meanwhile, a growing number of other states decriminalized recreational use to some degree.

Vermont became the first state to legalize recreational marijuana use by action of the legislature rather than by ballot initiative with the successful passage of the H. 511 bill in 2018. Notably, the bill only allowed for the recreational use of up to an ounce of cannabis, with sales of recreational marijuana still technically illegal (Speights, 2020). In Illinois, a broader bill legalizing recreational marijuana—including sales—was signed into law in 2019, effective in 2020; it also included a provision for expunging previous convictions for marijuana possession (Berke & Gould, 2020). In 2020, New Jersey, Montana, South Dakota, Arizona, and New York all approved measures legalizing some degree of recreational marijuana use. Virginia followed suit in 2021 (Hartman, 2021; Hansen & Alas, 2021). Following in 2021 were New Mexico and Connecticut. In 2022, Missouri and Maryland legalized recreational use, and in 2023, Delaware and Minnesota joined the group of states where recreational marijuana was legal (USNews.com, 2023).

Viewpoints

Various state laws have lifted restrictions on the cultivation, possession, and use of marijuana for medical purposes and extended protection from prosecution to physicians who recommend medical marijuana. Critics, however, charge that the language in these laws, mostly drawn by legalization supporters rather than legislators, is too vague. For example, Section 1(A) of California's Proposition 215 states that medical marijuana can be used to treat cancer, anorexia, AIDS, chronic pain, spasticity, glaucoma, arthritis, migraine, or any other illness for which marijuana provides relief. Critics argue that anyone wanting to buy marijuana legally can simply ask a compliant physician for a prescription to treat a pretended headache. Colorado's experience has been cited as demonstrating the need for clear policies in establishing regulations and licensure for growers and sellers.

In December 2004, the American Association for Retired Persons (AARP) conducted a poll that found 72 percent of seniors support medical marijuana. Thirty percent of respondents reported they had smoked marijuana. The testimony of large numbers of chronically ill people, many of them elderly, who claimed that marijuana helped alleviate symptoms more effectively and with fewer side effects overturned widespread assumptions about marijuana being strictly high-inducing and harmful. By 2014, a wide majority of Americans under thirty supported the legalization of nonmedical marijuana as well. In 2016, approximately 57 percent of American adults believed that marijuana should be legal, with 37 percent believing it should remain illegal (Geiger, 2016). In 2019 a Pew Research Center poll found the percentage of supporters had increased to 67 percent, while opponents had declined to 32 percent. The survey also found that 59 percent of American adults supported full legalization of both medical and recreational use, while 32 percent felt only medical use should be legal, and just 8 percent thought all use should be illegal (Daniller, 2019). By 2022, an overwhelming majority of adults in the U.S. believed in the full legalization of marijuana. Pew Research Center reported that 88 percent said either that marijuana should be legal for medical and recreational use or that it should be legal for medical use only. Fifty-nine percent supported both and 30 percent supported the medicinal use (Van Green, 2022).

In 2016, the legal marijuana market in the United States was estimated to be worth $7.1 billion and rapidly growing (Sola, 2016). By 2019 that figure was estimated to be over $12 billion (Speights, 2020). In 2022, the marijuana market had increased to $13.2 billion and was projected to reach $72 billion by 2030 (Grand View Research, n.d.). To many industry analysts, this suggested the legalization of recreational marijuana in more states that had already legalized its medical use. The growing presence of the industry has effects on other industries and the economy as a whole, but the disputed legality of the product continues to pose problems for clients and partners hoping to do business with marijuana sellers. Insurers and bankers must weigh the implications of working with businesses that could face federal penalties. State and local governments must consider zoning ordinances, prioritize enforcement of rules, and collect taxes. The fuzzy nature of federal policy also means it remains influenced by the specific approach of the current presidential administration.

In the 2020s, efforts have been made to reduce or release those in prison for simple marijuana possession. In 2022, President Joe Biden announced the pardon of 6,500 individuals convicted of marijuana possession at the federal level. Though none were serving prison sentences, removing the felony from their record meant they would no longer face obstacles in finding employment or housing. This pardon is especially important for Black Americans who are four times as likely to be arrested for marijuana possession (Bernstein, 2022).

Terms & Concepts

Analgesic: A drug or herb that suppresses pain.

Antispasmodic: A drug or herb that suppresses muscle spasms.

Cannabinoids: The chemical compounds secreted by cannabis: flowers that provide relief to a number of symptoms, including pain, nausea, and inflammation.

Hemp: A tall, widely cultivated plant that has a tough bast fiber used especially for cordage and that is often separated into a tall, loosely branched species and a low-growing, densely branched species.

Pharmacopeia: A reference book containing directions for the identification of compound medicines published by the authority of a government, medical society, or pharmaceutical society.

Sedative: A drug or herb that tends to calm, moderate, or tranquilize nervousness or excitement

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Suggested Reading

Cerdá, M., Wall, M., Keyes, K. M., Galea, S., & Hasin, D. (2012). Medical marijuana laws in 50 states: Investigating the relationship between state legalization of medical marijuana and marijuana use, abuse and dependence. Drug & Alcohol Dependence, 120(1-3), 22-27. Retrieved December 29, 2014 from EBSCO Online Database Academic Search Complete. http://search.ebscohost.com/login.aspx?direct=true&db=a9h&AN=70038328&site=ehost-live

Gorman, L. (2014). Consequences of legalizing marijuana, NBER Digest, 2-3. Retrieved December 29, 2014 from EBSCO Online Database Business Source Complete. http://search.ebscohost.com/login.aspx?direct=true&db=bth&AN=98591596&site=ehost-live

Marijuana and the Controlled Substances Act. (2014). Congressional Digest, 93(8), 2-6. Retrieved December 29, 2014 from EBSCO Online Database Academic Search Complete. http://search.ebscohost.com/login.aspx?direct=true&db=a9h&AN=99014947&site=ehost-live

Stringer, R. J., & Maggard, S. R. (2016). Reefer Madness to marijuana legalization. Journal of Drug Issues, 46(4), 428-445. Retrieved December 28, 2016 from EBSCO online database Sociology Source Ultimate. http://search.ebscohost.com/login.aspx?direct=true&db=sxi&AN=118049050&site=ehost-live&scope=site