IACM-Bulletin of December 21, 2003

USA — A federal appeals court ruled that the medical use of cannabis is allowed under certain circumstances

In a landmark decision, the Ninth Circuit Court of Appeals has ruled in support of both people who use medical cannabis and the constitutional principle of federalism. On 16 December the court ruled that the federal Controlled Substances Act of 1970, which outlaws the use of marijuana may not apply to sick people with a doctor's recommendation in states with medical marijuana laws.

In a 2-1 ruling the court said prosecuting these medical cannabis users is unconstitutional if the cannabis is not sold and transported across state lines or used for non-medicinal purposes. "The intrastate, noncommercial cultivation, possession and use of marijuana for personal medical purposes on the advice of a physician is, in fact, different in kind from drug trafficking,'' Judge Harry Pregerson wrote for the majority.

The case concerned two seriously ill Californian women, Angel Raich, who has an inoperable brain tumour, and Diane Monson, who suffers from severe back pain. They sued Attorney General John Ashcroft and asked for a court order letting them use, grow or obtain cannabis without fear of federal prosecution.

The case underscores the conflict between federal law and California's 1996 medical marijuana law. Alaska, Arizona, Colorado, Hawaii, Maine, Nevada, Oregon and Washington state have laws similar to California, which has been the focus of federal drug interdiction efforts. The ninth appeals court, the country's largest, does not have jurisdiction over Colorado and Maine. Legal experts expect the federal Justice Department to appeal the ruling before the Supreme Court.

(Sources: Associated Press of 16 December 2003, Reuters of 16 December 2003. Los Angelos Times of 16 December 2003, National Review of 19 December 2003)

Spain — Pharmacists of Barcelona want to distribute cannabis for medical uses

The organisation of the Barcelona pharmacists started to investigate the level of cannabis selfmedication, according to Rafael Borràs, speaker for drugs and AIDS affairs of the organisation. The investigation started in September and about 100 patients have participated until now.

Today, only nabilone, a synthetic derivative of THC, which is imported from the UK, may be prescribed by Spanish doctors. But Borràs proposes to make standardised cannabis available in pharmacies "under strict control and with a medical prescription" following the Dutch model. The people in charge of the report have the impression that the number of people using cannabis for medical purposes increased in Spain, but that it is not possible to quantify it. "We want to analyse what is happening," Borràs said. The study is investigating the reasons for the medical use of cannabis, its effects, and the ways participants of the survey obtain the drug.

Information on the medical use of cannabis is presented on the web site of the organisation:

http://www.farmaceuticonline.com/medicament/cannabis.html

(Source: La Voz de Galicia of 8 December 2003)

A U.S. medical marijuana advocate who sought refugee status in Canada had his claim rejected on 8 December. Canada's Immigration and Refugee Board ruled that Steve Kubby did not have a well-founded fear of being persecuted or tortured, or that there was any risk to his life, if he returned to his home state of California.

Kubby is among a handful of people who have moved to Canada in recent years to escape U.S. drug laws. He had argued he was a political target of the police because of his outspoken views in favour of medical marijuana. He had said the 120-day jail term he was ordered in 2001 to serve in California would be a death sentence. He claimed if he did not smoke cannabis every hour, he would die from complications from adrenal cancer. Kubby fled to British Columbia in Canada in 2001 to avoid the jail sentence.

The Board said it appeared cannabis was helping Kubby cope with the symptoms of his disease, but it was unclear if it was actually keeping him alive. It noted that he would have access to the drug under the California law. The Board also ruled against the refugee claims of Kubby's wife Michele and their two daughters.

(Sources: Reuters of 8 December 2003, Canadian Broadcasting Corporation of 8 December 2003)

News in brief

Canada — New prime minister and cannabis

Prime Minister Paul Martin said he will go ahead with legislation, first proposed under his predecessor Jean Chretien, to eliminate criminal penalties for possession of small amounts of marijuana. But he hinted he would like to see a new definition of a "small amount" and invited a parliamentary committee to consider lowering the limit from the original proposal of 15 grams. On the central point of the law, however, he insisted that it achieves "absolutely nothing to give a criminal record to young people caught with minimal amounts." (Source: Canadian Press of 18 December 2003)

Science — Neuropathic pain

The effect of repeated treatment with a synthetic cannabinoid (WIN 55,212-2) on the neuropathic pain induced in rats by chronic constriction of the sciatic nerve was investigated. Low doses of the cannabinoid administered daily throughout the development of neuropathy reversed the hyperalgesia (increased pain sensitivity). At 14 days after injury, the levels of substances known to be involved in neuropathic pain, such as prostaglandin E2 and nitric oxide were increased. Repeated treatment with WIN 55,212-2 abolished these increases. (Source: Costa B, et al. Br J Pharmacol 2003 Dec 8 [electronic publication ahead of print])

Science — Drugs and violence

The likelihood of physical aggression against their partners in dependency of drug use was examined in 149 men during a 15-month period. The likelihood of physical aggression on days of no drug use was compared to the likelihood of aggression on days of drug use. Of the psychoactive substances examined, the use of alcohol and cocaine was associated with significant increases in physical aggression, while cannabis and opiates were not significantly associated with an increased likelihood of male partner violence. (Source: Fals-Stewart W, et al. Addict Behav 2003;28(9):1555-74)