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FEATURE
How Cannabis Became Marihuana and How Marijuana Became Medicine
©2004
by Keith Saunders, Ph.D.
This article examines the historical, cultural and economic
transformation of the plant cannabis sativa L. from a widely
valued natural resource to a demon drug in the U.S. during the 20th
century, and the present-day struggles between patients and care
providers who seek to use cannabis medically and the DEA and other
federal agencies. Using ethnographic methods, document searches and
personal interviews, the author locates the conflict within broader
issues of federal vs. local authority, social policies and identity
formation, social movements and censorship.
Cannabis Sativa L.
is indigenous to Central Asia (U.S. Dept. of Agriculture 1914; Haney
and Kutschied 1975), it was cultivated in China as far back as 3,000
BCE (Grinspoon and Bakalar 1993: 3). The practice of cultivating
cannabis had spread to Europe prior to transatlantic crossings and was
harvested in the New England colonies beginning in 1629 (Maisto, et
al. 1995: 314). Cannabis was valued for its strong fibers, used to
make paper, rope and cloth.
The “Indian hemp”
plant had been utilized as medicine by the Chinese and Sumatrans more
than 5,000 years ago (Russo, 2001). The medical properties of the
plant were studied by Irish physician W. B. O’Shaughnessey, while
working at the University of Calcutta. In 1839 O’Shaughnessey
published what is believed to be the first scientific medicinal
investigation of the effects of consuming cannabis; soon after,
western physicians began to use cannabis in the treatment of their
patients. Cannabis was listed in the United States Dispensatory
in the middle of the 1850s.
The practice of using cannabis to treat headaches, spasms,
nausea and other maladies is necessarily cultural. The plant does not
direct people to prepare it in ways that allow its active components
to enter the bloodstream; these actions must be discovered and
taught. Similarly, the use of cannabis for pleasure is also a
cultural practice:
The hemp plant was present in Jamaica at least as early as
the late eighteenth century, but there is strong circumstantial
evidence that its therapeutic and psychoactive uses were only
introduced in the mid-nineteenth century by indentured workers who
were brought to the West Indies from India after the abolition of
slavery. Between 1845 and 1917, about 36,000 Indians came to Jamaica
and it is estimated that about 18,000 remained when indenture ended.
There is no mention made of its use in the pre-emancipation period and
African names for cannabis such as Kif or Dagga are not in folk use in
Jamaica. On the other hand there are striking similarities between
Jamaican and Indian cultural beliefs about ganja, methods of
preparation and use of the drug. Hindu names like ganja, kali, and
chilam, are all in common use among working-class Jamaicans. (Bearbrun
1983:71-2).
The modern epistemic broke the plant into its constituent
parts, isolating them and thus decontextualizing cannabis sativa
from “a plant of many uses” to a plant of many pieces. Unlike the
poppy, papaver somniferum, whose opium was soon mined for
morphine, codeine, and diacetyl morphine (branded “heroin”), 19th
century physicians and pharmacists were not able to identify the
cannabinols—this did not happen until the late 1960s, in Israel
(examination of medicinal properties had been federally banned in the
U.S. beginning in 1937). With an isolated focus on the psychoactive
properties, we see a change in how the consumption of cannabinols, and
Δ-9-Tetrahydrocannabinol in particular, was managed.
To understand how cannabis went from an era of nascent
scientific medicinal investigation into a period of imposed ignorance,
one must look at the recasting of cannabis in American culture and the
growing relationship between the professions of physician, pharmacist
and federal bureaucrat in the first half of the 20th century. Of the
massive changes involving federal regulation of drug sales, taxation
of narcotics, and ultimately prohibitions of alcohol, heroin and
later, marihuana, one of the few constants is the qualities of the
drugs themselves. The culture changed—cannabis stayed the same.
The earliest treatment of the cannabis users as an identity
group in the West is entwined with the symbolic order of racial and
ethnic identity in the late 19th and early 20th centuries. Bonnie and
Whitebread (1974, 1999) provide a thorough documenting of how the
discursive identity of the cannabis user became attached to Mexican
immigrants in the western states and African-Americans in Texas and
along the Gulf Coast. At the same time, cannabis was beginning to be
called a “narcotic.” As physicians were simultaneously writing a
history of their patients being treated with cannabis, those who would
use cannabis on their own, for other purposes, would also become
subjects of their Foucauldian gaze.
Alongside the medical history of the cannabis user we find
the writing of the statutory history. The creation of marihuana (and
other drug) statutes can be read as a history of the nation-state
realizing itself upon the bodies of its population. Between the Opium
Den Act in California in 1874 and the Volstead Act that federally
prohibited alcohol in 1918 we find a pattern of the state conspiring
with the practitioners of scientific medicine to create professional
controls over access to and use of “illegal” drugs, and to place the
producers and consumers of “illegal” drugs under the authority of the
penal system. Thus the identity of the drug-user became ensconced in
the medical and state literatures, to live out a history that would
allow only submission and resistance, and where resistance itself
signals the need for control.
The first attempts to place cannabis under the control of law
occurred in the 1911 in Louisiana, which enacted legislation
prohibiting the refills of cannabis prescriptions (Bonnie and
Whitebread 1999: 48). The 1914 Harrison Narcotics Act granted
physicians and pharmacists a monopoly control over the legal (taxed)
dispensation of opiates and cocaine; cannabis and chloral hydrate were
originally covered by the legislation, but were removed from the bill
in 1913 (Musto 1987: 59-68). Non-medicinal cannabis use was uncommon
outside of the South and West, and the regional concern over its use
and users did not spread to the federal regulation (see Bonnie and
Whitbread 1974, 1999). The step toward greater government and
professional controls over drugs was maintained in spirit by those
individual states that would prohibit the non-medical and medical use
of cannabis the years 1911 through 1933.
During the “local” phase of marihuana prohibition, lasting
roughly from 1911 to 1931, twenty-nine states, including seventeen
west of the Mississippi, prohibited the use of the drug for nonmedical
purposes. (Four more states did so in 1933).
The most important feature of this initial prohibitory phase
is that marihuana was inevitably viewed as a “narcotic” drug; thereby
invoking the broad consensus underlying the nation’s recently
enunciated narcotics policy. The classification emerged primarily
from the drug’s alien character. Although use of some drugs—alcohol
and tobacco—was indigenous to American life, the use of “narcotics”
for pleasure was not. Evidently, drugs associated with ethnic
minorities and with otherwise “immoral” populations were automatically
viewed as “narcotics.” The scientific community shared this social
bias and therefore had little interest in scientific accuracy…
In short, marihuana prohibition was a predictable
phenomenon. In states where either Mexicans or the weed had appeared,
suppressing its use required no public clamor or citizens’ movement;
soon after being appraised of its presence, local lawmakers invoked
the criminal law, and some turned to Washington for assistance (Bonnie
and Whitebread 1999: 51-2).
By the 1930s cannabis had fallen out of favor with most of
the scientific medical community, for the tendency of practitioners to
prefer isolable substances (cannabinols had yet to be isolated), as
well as the generally assumed superior capacity for synthetic
substances to treat specific ailments. Without active support by
physicians, cannabis was open for demonization. The term “marihuana”
was brought into the political discourse in the 1910s, taken from the
patois of users. When lifelong bureaucrat Harry Anslinger introduced
legislation that would effectively prohibit cannabis in the 1930s, the
subcultural referent provided a useful smokescreen against those who
traded in all the other parts of the plant.
“I use the word ‘cannabis’ in preference to the word
‘marihuana.’ Because cannabis is the correct term for describing the
plant and its products…Marihuana is not the correct term. It was the
use of the term ‘marihuana’ rather than the term ‘cannabis’ or the use
of the term ‘Indian hemp’ that was responsible, as your realized…for
the failure of the dealers in Indian hempseed to connect up with this
bill with their business until rather late in the day…I say the
medical use of cannabis has nothing to do with cannabis or marihuana
addiction. In all that you have heard here thus far, no mention has
been made of
excessive use by any doctor or its excessive distribution by any
pharmacist. And yet the burden of this bill is placed heavily on the
doctors and pharmacists of the country; and I may say very heavily,
most heavily, possibly of all, on the farmers of this country.
“…We object to the imposing of an additional tax on
physicians, pharmacists and others, catering to the sick; to require
that they register and reregister; that they have special order forms
to be used for this particular drug, while the matter can just as well
be covered by an amendment to the Harrison Narcotics Act”—Dr. William
C. Woodward, Counsel to the American Medical Association, in testimony
given in the Hearings on the Marihuana Tax Act before the House
Committee on Ways and Means, 75th Congress, 1937.
Marihuana was federally prohibited in 1937; there was no
collective shock or outrage at the prohibition, for most Americans,
cannabis had never been given much thought. The prohibition of
alcohol in 1919, itself a culmination of a 70-year old temperance
movement, was resisted from its origins by producers and consumers of
the drug. There is no record of a coordinated resistance to the
prohibition of cannabis, save for Dr. Woodward and the Indian hemp
(bird) seed producers—who voluntarily began to sterilize their
supply. The marihuana users were typically located on the margins of
society, they were racial minorities living in the Jim Crow south or
major urban areas of the Rust Belt and northeast, they were musicians
and visual artists, and they were migrant workers. As Howard Becker
showed in his classic study of marihuana users and jazz musicians,
Outsiders (1964), the marihuana users constituted a subculture of a
sort, people who found in each other a similarity that the “squares”
could never understand and the straight life could never accommodate.
Between 1937 and the later 1960s, the prohibited status of marihuana
forced people to acquire specialized knowledge of distribution
networks if they were ever to become “marihuana users.” After 1967,
however, the use of marijuana (now spelled with a ‘j’) burst from the
jazz joints and beatnik poetry slams to spill across the entirety of
the popular culture.
Far from controlling cannabis, the special attention given
the plant by the federal government helped make the practice of
administering cannabinols more popular than ever. The prohibition of
marijuana (or any drug) as a policy has never been able to effective
halt the propagation of knowledge of its existence, how to use it, and
what it is to be affected by it. Prohibition codes such knowledge as
“illicit,” and thus bestows it a quality that cannot exist without
such ranking. The creation of categories of illicit knowledge
supposes a curative method be applied to those who have known that
strikes at the source of desire to know such a thing at all. The
problem is not one of the status of the knowledge but of the existence
of the knowledge itself. Such problems would then be best addressed
by the removal of such knowledge and a vigilant censorship to deter
its rediscovery.
While marijuana use was becoming exponentially more popular
and public during Nixon’s first term, he commissioned a panel to
examine marijuana. It would be the second major study of the drug,
the first was commissioned by New York City Mayor Fiorello LaGuardia
in the 1940s, the Commission found the various pathologies attributed
to cannabis use (insanity, personality disorders, violence, sexual
assault) were not supported by any empirical data. Nevertheless, the
law remained unchanged in New York and the rest of the nation.
Nixon appointed Raymond Shafer, Governor of Pennsylvania,
chairman of the Commission. Nixon expected the Commission to follow
his lead on drugs and crime:
RN:
“Now this is one thing I want. I want a Goddamn strong statement
on marijuana. Can I get that out of this sonofabitching thing, uh
Domestic Council?”
HRH: “Sure.”
RN: “I mean one
on marijuana that tears the ass out of them…By God we
are going to hit the marijuana thing, and I want to hit it
right square in the puss…I want to hit it, against legalizing and all
that sort of thing.”
May 26, 1971, Time: 10:03 am – 11:35 am—Oval Office
Conversation: 505-4—Meeting with Richard Nixon and HR ‘Bob’ Haldeman.
The Shafer Commission issued its final report in 1972,
titled, “Marijuana: A Signal of Misunderstanding,” it recommended
ending federal criminal penalties for the possession of small,
personal amounts of the drug. The White House ignored the findings
and tried to keep a lid on the report.
A copy of the report was secured by R. Keith Stroup, Esq.,
who had started the first national-level marijuana consumers lobby,
the National Organization for the Reform of Marijuana Laws (NORML), in
1970. NORML sued the DEA to have marijuana rescheduled under the 1970
Uniform Controlled Substances Act. The case lasted 16 years, “It was
the third-longest civil case in American history,” notes NORML
Foundation Executive Director Allen St. Pierre. DEA Administrative
Law Judge Francis R. Young ruled in NORML’s favor in 1988, stating,
“In its natural form, marijuana is one of the safest therapeutically
active substances known to man.”
An organized marijuana policy reform movement originated in
1964 with the group LeMar (short for “Legalize Marijuana”) starting
chapters in San Francisco and New York. LeMar grew to near a dozen
state-level chapters before merging with Amorphia: The Cannabis
Collective, based in California. Amorphia merged with NORML in 1974.
NORML was the first reform organization to focus on federal
prohibition, and unlike most of its predecessors, NORML specifically
included “Medical Use” of cannabis in their earliest policy
advocacies.
In the context of 1970s marijuana reform, the medical and
commercial uses of the hemp plant were side issues, easily remedied by
eliminating all government controls over the cannabis plant and thus
achieving Amorphia’s goal of “Free, legal, backyard marijuana”
(Aldrich 1980). The changing public sentiments regarding marijuana
can be attributed to both the rapid spread of first- and second-hand
knowledge of the actual effects of the drug (understood to be
generally pleasant and not nearly as debilitating as 50 years of
anti-drug propaganda had promised), and the increasing number of NORML
members and other activists. By 1976, presidential candidate Jimmy
Carter advocated the federal government removing all penalties for
personal possession of marijuana, and allowing the states to make
their own laws regarding the cannabis plant. By 1979, eleven states
had decriminalized the personal possession of marijuana and one of
them, Alaska, allowed for the production of up to four plants (and
possession of up to four cultivated ounces) in the home.
1979 was a touchstone year for marijuana in the U.S. Current
use rates hit their highest level ever and in the preceding 10 years
more than 25 million Americans had used marijuana at least once. It
was not unusual to see a lobbyist for the paraphernalia industry
walking the halls of Congress, and Keith Stroup was feted by
politicians (the Carter family), performers (Willie Nelson), and
publishers (Hugh Hefner), alike.
The culture was rapidly changing again, though, and when
Carter’s chief drug policy adviser, Dr. Peter Bourne, was left
unprotected by Stroup from charges that he used cocaine at a NORML
party, everything seemed to turn 180-degrees, in just a matter of
weeks.
Bourne and Stroup were forced to resign, Carter withdrew
support for reforming the marijuana laws, and Ronald Reagan ran for
the Presidency on a conservative, morals-based platform. The drug
temperance movements would have a champion in the White House and
politicians from both major parties would spend the better part of the
next decade trying to outdo each other in crafting the most punitive
and repressive drug prohibition legislation in the nation’s history.
Nixon had declared a War on Drugs in 1970, but his priority was to
make treatment and rehabilitation more readily available to the
public. The Reagan administration took the other tack: Increasing
penalties across the board, establishing a two-tiered domestic
enforcement system which added penalties to drug crimes committed in
school zones, initiating what would later be ruled an unconstitutional
policy of civil forfeiture in drug cases, and directing more than 70%
of the Drug War budget on interdiction, incarceration and
enforcement. The treatment and education side also received a boost
in funding, but a large portion of that was dedicated to promoting the
DARE curriculum in public schools, rather than moving toward
treatment-on-demand for those who sought it.
The segregation of knowledge was important for the Reagan-era
Drug War. Illicit marijuana-knowledge was everywhere, from the
personal interactions of users, to entertainment genres in film,
comedy and music, to references in popular TV shows such as Saturday
Night Live. DARE would teach a growing generation to disdain the
thought that marijuana has any redeeming social value, “to think for
themselves and Just Say No,” and to report on anyone (including their
parents) who used “drugs.” Subsequent examinations of the DARE
program have found it to be ineffective, at best, and potentially
counterproductive, making its graduates more likely than their
non-DARE peers to use illegal drugs.
By the late 1980s the only legitimate advocacy for cannabis
was in the vein of commercial hemp, and that was often couched in a
language of environmentalism. The recreational use position was all
but dead; a number of states that had decriminalized marijuana in the
1970s began to re-criminalize it, new user rates had been declining
since 1980 and would continue to do so until 1992. Medical advocacy
was a curiosity, and much like at the time of marijuana’s initial
prohibition, medical users were typically on the margin. It had long
been recognized that marijuana helped alleviate nausea associated with
chemotherapy and radiation treatments, but there was no particular
organization established that would frame marijuana policy reform as a
medical issue, first and foremost. By 1992, when Bill Clinton said,
“I smoke it, but I didn’t inhale,” and Clarence Thomas was confession
to Congress that he, too, had used marijuana while in college, NORML
was on life support. The staff had been reduce to one full timer,
rent had not been paid in a number of months, the telephones were
within hours of being disconnected, and the IRS had audited the
organization.
The marijuana policy reform movement found sponsors from two
new sources in the 1990s: first, billionaire George Soros would found
the Lindesmith Center; and it turned out that many of the new
millionaires whose riches came from the burgeoning computer industries
either enjoyed using marijuana, were economic libertarians, or both.
The rapid influx of capital, along with a slow, steady rise in current
use rates and the number of users, made marijuana policy reform
imaginable again.
The 1990s version would take NORML’s original advocacy
position and stand it on its head. Medical marijuana would be the
first point of advocacy, commercial hemp second, and legalization for
recreational use had been supplanted by working for decriminalization
at the state and federal levels.
In 1996, California voters approved Proposition 215, which
made medical marijuana legal for patients in the state. Arizona
voters also approved a decriminalization/medical marijuana measure,
Proposition 2000, that same year. Oregon, Alaska and Washington
voters approved ballot initiatives in their states in 1998, Maine in
1999. Nevada voters approved Question 9, Colorado voters approved
Amendment 20 in 2000, and the Hawaii legislature passed legislation
that year making medical marijuana legal for qualified patients.
Maryland approved an affirmative medical defense law in 2003, allowing
patients charged with cannabis law violations to introduce medical use
as a legitimate defense. On July 1, 2004, Vermont Senate Bill 76
became law without the governor’s signature, it allows patients
“diagnosed with a debilitating medical condition” to possess up to 2
ounces of cultivated marijuana, and grow up to 3 plants with no more
than 1 at maturity at any given time.
The states are beginning to reform cannabis laws because
people are successfully using marijuana as medicine. Over the course
of prohibition, and especially as related to slow HIV and AIDS drug
development in the 1980s, anecdotal evidence of the therapeutic
benefits of cannabis began to spread as an illicit form of
marijuana-knowledge. Today, some state laws specify the conditions
for which marijuana may be recommended, including: anorexia; cachexia;
cancer; Crohn’s disease; chronic nervous system disorders; chronic
pain; epilepsy and other seizure disorders; glaucoma; hepatitis C; HIV
and AIDS; multiple sclerosis and other spastic disorders; and nausea.
Michael Aldrich, Ph.D., founder of Californians Helping
Alleviate Medical Problems (CHAMP), has hypothesized that the specific
medical properties of the cannabis plant: analgesia, anti-emetic,
anti-inflammatory, anti-spasmodic, appetite stimulant, et cetera, are
due to the proportions of the “lesser” cannabinols to the amount of
Δ-9-THC. There are 60 identified cannabinols, at least one of these,
cannabidiol (CBD), is believed to counteract the effects of Δ-9-THC,
apparently by occupying receptors in the brain. In the late 1990s
researchers identified the first endogenous cannabinol, named
Anandamide (Russo 2001).
Outside of the U.S., the medical applications of cannabis can
be studied with less interference by governments, even where cannabis
is prohibited—a testimony to the priority the U.S. places on
prohibition and its inherent logic of censorship. The British GW
Pharmaceuticals has developed a sublingual delivery system for
cannabinols that was so successful in testing on MS patients that it
was approved prior to the scheduled end of the experiments. In
comparison, the DEA has been required to grow medical cannabis for
U.S. patients enrolled in the Compassionate IND program. The medical
cannabis program began in 1975, when the late Robert Randall became
the first patient. Fewer than 15 patients were enrolled in the
program in its 19 years of admitting people—the barriers placed in
front of physicians who sought government-grown medical marijuana were
nearly insurmountable. The program has five surviving patients who
receive 300 pre-rolled joints a month, in a large tin with the
prescription for “cannabis flos.” affixed to the side. Recently, Rick
Doblin, Ph.D. received permission by the courts to establish a second
medical cannabis farm; the federal government continues to resist, and
Doblin has again filed suit to require the DEA to provide seeds.
To medical marijuana activists, the government’s position is
a contradiction: cannabis is both prohibited and legal; the DEA posits
that marijuana has no medical value and a high potential for abuse,
yet the administration is the sole provider of licit organic cannabis;
Dronabinol, orally administered, synthetic Δ-9-THC suspended in sesame
oil is legally available as a schedule II substance
The contradictory dynamics of the prohibition and medical
application of cannabis are playing out in culture and the economy.
As the didactic of cannabis reform has rescued a message of legitimate
marijuana-knowledge from the ashes of the 1970s legalization
movements, the cultural struggle over defining the place of cannabis
seems to increasingly split between the government’s focus on the
uncertainty of effects and dangers posed to children, and the medical
users and activists’ insistence on the viability of cannabis as a
medicine and the value it can offer patients. Economically, the
conflict is one between large capital and entrepreneurs. The
entrepreneurial production of cannabis in its organic form is
prohibited, however the synthesis of Δ-9-THC by a large pharmaceutical
company was patented and licensed. This distinction—never made
explicit in legislation—indicates a federal strategy is emerging to
control cannabis in the proximate future: synthetic and patented
cannabinols will gain purchase; genetically engineered and patented
cannabis plants (with altered morphology to distinguish them from
nature’s version) will be licensed and developed for the production of
commercial hemp and perhaps a small amount of medical experimentation;
organic cannabis (“marijuana”) will be a sure and immediate indicator
that the possessor is a criminal.
Framed by patients’ right to use safe and effective medicine
for the treatment of legitimate conditions, the cannabis policy reform
movement is a formidable opponent to the total prohibition of
cannabis. The focus of the federal government’s efforts since 1937
has been to maintain the total prohibition of cannabis, regardless of
any value users may derive from it. The monolithic push by
bureaucratic prohibitionists has forced them to adapt their strategies
accordingly, when encountering the new advocacies of the 1990s and
beyond. Since marijuana must be kept prohibited, the focus is on
discrediting reformers’ claims, and raiding those who would prove the
federal policy inaccurate where it claims marijuana to be absent any
medical value whatsoever. The DEA is not in the business of treating
the sick, and should people suffer and die from conditions that could
safely and effectively treated by medical cannabis, that is just the
collateral damage of the drug war.
Prohibition must be enforced at all costs: culturally, we
must code knowledge and make efforts to silence or dismiss those who
would share illicit knowledge; economically, capital must sacrifice
its potential exploitation of a valuable domestic resource and the
nation must lose tax revenues and run a hemp trade deficit.
To understand where we are going, we need to look at how and
why a century of medical cannabis use in the U.S. (and millennia of it
elsewhere) could be swept away in the 1930s, we need to examine the
means by which the total prohibition of the cannabis plant was
justified, and we need to reconsider the choices made to place
cannabis and a few other drugs under the control of law enforcement,
rather than medical communities. More than 70% of Americans believe
marijuana should be made available to patients under a doctor’s
supervision, and this is showing in state policies enacted in the past
8 years. The DEA, ONDCP, and large pharmaceutical and agricultural
corporations have the lion’s share of economic resources, and
ubiquitous access to print and electronic media to get their messages
across. It is not working. Small bands of policy reformers and
brave, sometimes desperate, patients and care providers have put their
shoulders to the wheel, and it is rolling. In the face of arrest,
asset forfeiture, and imprisonment, these souls call us to join them
in breaking down prohibition, America’s Berlin Wall.
Keith Saunders,
Ph.D. is a sociologist whose work focuses on drugs, drug policies and
social movements. He has been recognized by cannabis policy reformers
for his dissertation An Ethnography of Marijuana Policy Reform Groups
and Marijuana Culture, and he has presented his findings at the Annual
Meeting of both the American Sociological Association and the Society
for the Study of Social Problems. Dr. Saunders has taught sociology
for 11 years in the Boston area, he is a Director of the Massachusetts
Cannabis Reform Coalition and a past speaker at the NORML National
Convention. In August 2004 Dr. Saunders organized and presided over a
Regional Spotlight Session at the Annual Meeting of the American
Sociological Association entitled, “It’s Not Easy Being Green: Medical
Marijuana and Community Health Care,” featuring reformers, patients
and activists in the San Francisco Bay area.
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