Conyers' Letter to the DEA and Medical Marijuana Trojan Horses

May 15 2008 Published by under Cannabis

Representative John Conyers, Chair of the House Committee on the Judiciary, sent a letter to the DEA inquiring about the "paramilitary style enforcement raids" conducted against medical marijuana distributors in California. In case anyone hasn't been following this story the state of California permits the use of marijuana for medical purposes. Since the federal government does not and the current Federal apparatuses' have chosen not to look the other way in respect of State's rights, there have been Federally motivated enforcement actions against people and businesses that are legally permitted by the State but not the Federal government.
Ed Brayton observes:

All of this can be blamed entirely on the Supreme Court, which issued one of the most indefensible rulings in its history in Gonzales v Raich. And yes, this one you can lay directly at the feet of the liberals on the court. Stevens, Souter, Ginsburg and Breyer were all in the majority in ruling that the federal government has the authority to overrule state medical marijuana laws.

I ran across something specific related to this Conyers' letter that ties back to some previous comments I had about drug advocates trying to Trojan Horse recreational use under cover of medicinal use.


First, let me be clear about the medical marijuana thing. Did you watch the repeated ambushing of Presidential candidates by patients with various conditions attesting to their need for marijuana? If not, start here and follow the related videos.

I am not inclined to disbelieve medical marijuana patients out of hand, in fact rather the contrary. First, we know from anecdotes accessible to nearly everyone who has come across a dope smoker, popular media and indeed good quality research that marijuana smoking stimulates appetite. A GoodThing in cases of cancer cachexia and AIDS wasting. We know from a currently active area of research (see juniorprof) that cannabinoid sensitive mechanisms are involved in pain, so there is reason to assume a specific effect of marijuana smoking to relieve some chronic pain conditions. It takes only a rudimentary understanding of the risks of marijuana smoking to be able to come to a conclusion about how much we should care if the individual with a (near) terminal condition (such as AIDS) or threatening complication (cachexia in cancer or AIDS) becomes addicted to marijuana. One might need a slightly more involved appreciation of the relative risks of marijuana smoking and typical prescription medications for pain control but suffice it to say most of the good pain medications are opiates. Which carry their own addiction / dependence risks.
Furthermore, let me give major props to the State of California for funding at least one clinical research effort on the topic of medical marijuana. The individuals involved in that effort are very highly regarded clinical researchers- most of whom are involved with clinical AIDS research so their major motivation may be assumed the application of medical marijuana for AIDS-related wasting. [Update: as luck would have it, PalMD just posted an overview of HIV infection.] YHN is very much in favor of political entities that attempt to generate good scientific information when they plan or start new policies that could benefit from such.
With all that said, there is a list of drug busts appended to Conyers' letter and also an accounting here. I've been discussing this issue with a Reader who has some interesting observations.

Actually I have a little personal knowledge of one of these busts [of a distributor of medical marijuana-Ed]. The owner of one lived within a few blocks for several years and on my actual block for many months. This upstanding citizen may have been distributing medical marijuana, I guess, but this was also a good old fashioned drug dealer and abuser. Significant rage issues in the neighborhood, going all nonlinear shouting and threatening his neighbors at the slightest provocation. Cars pulling up to the house for people to dart in for 5 min at all hours [medical marijuana distribution was through a storefront location-Ed]

To summarize a little background, this individual lived in a nice family neighborhood with a couple of dozen elementary school and younger kids around. Lots of retirees as well. The neighborhood was all familiar with the disruptive antics and the evidence of the distributor in question appearing high at times as well as the parade of short-duration house visits. Not to mention the willingness of this supposed medical marijuana distributor to be a vocal defender of rights to distribute medical marijuana in the press. Usually associated with actions by the authorities against the individual. The people were well aware of the seeming end of the story in which the distributor went down on Al Capone type charges. I.e., other criminal behavior not directly related to the drug charges.
In short, this reasonably vocal defender of medical marijuana was clearly a drug dealer, first and foremost, who latched onto the issue to cover dealing. In short, a Trojan Horse advocate. Essentially single-handedly this person ensured that an entire neighborhood (of a consistently voting and reasonable liberal bent says my correspondent) would be very skeptical of efforts to legalize marijuana for medical purposes.
A commenter previously asked what I would suggest for strategies to advance public policy related to drug abuse science. Obviously, one major point is to completely divorce medical-use advocacy from personal-use advocacy. Another is to rigorously distance oneself or one's argument from drug dealers who are clearly recreational-use dealers first and medical marijuana providers only for convenience or market share.
In a tangentially related note, Bob Egelko of the SF Chronicle overviewed positions taken on the matter by Presidential candidates Obama, Clinton and McCain.

21 responses so far

  • Pete Guither says:

    Of course, the easiest and most effective solution is to legalize and regulate marijuana (like alcohol) so you take the decisions out of the hands of the criminals and put them into public policy.

  • Pierce R. Butler says:

    Conyers is a member of the House of Representatives, not a Senator.
    And where are those individuals who favor both medical and recreational uses of marijuana supposed to go?

  • Colin says:

    The problem here is that there is no recognized provision in CA law about growing pot for distribution centers. In order to grow pot you technically need a perscription and thus in order to stock the distribution centers they need a bunch of people with cards willing to grow more plants then they need but up to they're legal limit.
    So as you can see, distribution centers themselves are in a legal gray area and probably most of them are at least slightly breaching the law. And it's likely that a lot of their suppliers are also growing more plants then they are technically allowed. It's reallly in the distribution centers best interest to allow this too because it's the more prolific growers who take it seriously and make consistantly higher grade marijuana.
    It's all really gray and anarchistic as a result of the fact that the law was so halfassedly written. A lot of this could be solved if medical marijuana distribution centers were made legal with different rules than personal patient growers. Allow distributors and suppliers to have larger grow limits but more oversight.
    To see why this is an issue imagine the chaos that would happen if ritalin were made only legal for people to make if you had a perscription. In order for a center to distribute large amounts of Ritalin every one of their suppliers would need a perscription and would needyo produce more then they need but only in batches up to their legal limit. However it's also in the distribution center's best interest to find skilled producers of Ritalin who do it full time and professionally enuogh to have consistent batches... You can see how fast that would fall apart.

  • DrugMonkey says:

    Rep Conyers, right. Good catch, my bad. Perhaps some wishful thinking.
    as far as dual-legalization advocates go...shrug. My point here and elsewhere is that people who advocate medical uses of recreational drugs like MDMA and cannabis who also are obviously and overtly recreational users and recreational use advocates undercut their arguments. It is my belief (which may be unsupported) that there is a critical population of people (including politicians) who may be susceptible to medical use arguments but not susceptible to recreational use arguments. I think the passing of medical marijuana initiatives in various states, compared with the lack of success of recreational-use initiatives, testifies to this state of affairs, no?
    I suppose dual-advocates should ask themselves the hard question, starting with "Am I just a Trojan Horse advocate?".
    The problem here is that there is no recognized provision in CA law about growing pot for distribution centers.
    Indeed. It is a huge problem that CA failed to really grapple with the supply issue. One of the reasons they didn't is because licensing cannabis-selling businesses in the normal sense would've almost certainly run afoul of the Fed, whereas permitting personal use was viewed as sufficiently gray.
    the easiest and most effective solution is to legalize and regulate marijuana
    For medical use only? Obviously. I'm sure you are not suggesting for nonmedical use because this was not part of what CA did with that law.
    Actually the simplest solution would be for CA to buy some cigarette manufacturing equipment, set it up somewhere and use all of the copious amounts of seized marijuana to make joints for distribution through the local pharmacies. Since you are after "easiest" and "most effective" solutions for the legitimate medical marijuana patient you'd no doubt be satisfied with such a solution?

  • DuWayne says:

    This sounds a lot like Oregon's issues with medical marijuana. Except that it is legal for "caregivers" to grow larger amounts, so as to supply others who may be unable to grow it themselves. Even then, it is not legal to sell, even to those with a prescription card. Apparently, though it's not specified in statute, caregivers can require that the patients they provide for help them recoup their growing expenses.
    In practice many "caregivers" sell to their patients and some will happily sell to people who don't even have the card. The system is rife with abuse that has done a fair amount of damage to public perception of the medical marijuana law.
    Actually the simplest solution would be for CA to buy some cigarette manufacturing equipment, set it up somewhere and use all of the copious amounts of seized marijuana to make joints for distribution through the local pharmacies.
    I have more than one friend who would like to see this happen. Conversely there is also a movement to set up cooperatives who's activities would be on record and open to auditing by regulatory agencies. This would still make for potential abuse of the system, but it would certainly put a damper on the very worse abuses. It would also ensure that people who have the medical marijuana card could have reasonable, less prohibitively expensive access to the medicine that a doctor has prescribed for them.
    The debacle that is medical marijuana is indicative of why I believe in legalization, not decrim. Regulation is an important component of making illicit drugs licit.

  • juniorprof says:

    DM, I'd just like to add that in the pain and cannabinoid research field there is virtually no support for medicinal cannabis for pain control except in two conditions: End of life pain control for cancer and AIDS patients (overlapping largely with wasting conditions) and totally uncontrolled neuropathic pain (the worst of the worst, who get no relief from anything). There is, on the other hand (and as you are well aware), strong support for peripherally selective cannabinoids to avoid psychotropic effects and abuse but still give analgesia. All the evidence to date suggests that such synthetic cannabinoid compounds can give much stronger pain control without central side effects. Several are in clinical trials now.

  • DrugMonkey says:

    DM, I'd just like to add that in the pain and cannabinoid research field there is virtually no support for medicinal cannabis for pain control except in two conditions...All the evidence to date suggests that such synthetic cannabinoid compounds can give much stronger pain control without central side effects.
    If I take you correctly you are clarifying that most pain research scientists are not advocating dope smoking but are rather trying to come up with cannabinoid-related compounds that can provide pair relief without the drawbacks of dope smoking. This was not my intent with that comment, no. (Of course you realize that you are opening yourself up to the typical accusation that scientists are all just conspiring as BigPharmaShills to create an expensive medication where good old, cheaply grown (if legal) cannabis does the trick!)
    I was pointing out that there is good evidence that cannabis smoking is not just making one feel good or insensate to compensate for the pain (alcohol might be the example here) but rather has specific mechanistic reasons for working to relieve pain.
    I am not certain that this idea of a specific mechanism plays a very big part in the public understanding...and it should.
    Several are in clinical trials now.
    That might be an interesting post for you to write- if it doesn't violate physioproffian prohibitions about wasting efforts for which you might otherwise receive traditional academic credit...

  • juniorprof says:

    Okay, so first off, on being a shill for Big Pharma, this is an easy one. Cannabis smoking has abuse potential (as you well know). Look at the societal impact of opioid abuse even within the "I take it for pain control" population, why open a new can of worms when it can be avoided? There is a strong case for peripheral cannabinoids for pain control. I just happen to think the MOA is different from the commonly held view. There is little question that smoked cannabis cannot stay peripheral and that you will eventually have to deal with abuse and tolerance. Which is more expensive? I think abuse potential. Moreover, there are some academic cannabinoid development programs (see for instance the AM series compounds, the JWHs and the VDMs). Its unlikely, but one of these could end up being first to market.
    I was pointing out that there is good evidence that cannabis smoking is not just making one feel good or insensate to compensate for the pain (alcohol might be the example here) but rather has specific mechanistic reasons for working to relieve pain.
    You have summarized a point I was trying to get across much better than I could here. There is a rich literature showing that these things can be pharmacologically/anatomically separated on multiple levels with cannabinoids. The public needs to know more about this because they have paid for this wealth of knowledge over the past 20 years. Cannabinoid pharm development programs die off all the time due to political concerns. This is truly too bad and, moreover, is a waste of this large public investment.
    That might be an interesting post for you to write- if it doesn't violate physioproffian prohibitions about wasting efforts for which you might otherwise receive traditional academic credit
    I would love to write such a post but I am fairly sure I have other obligations that would keep me from doing so. I can check that one out though. It'll be obvious what the answer is in a few days.

  • juniorprof says:

    That might be an interesting post for you to write- if it doesn't violate physioproffian prohibitions about wasting efforts for which you might otherwise receive traditional academic credit...
    Alright, Done!
    http://juniorprof.wordpress.com/2008/05/15/the-rationale-for-cannabinoids-as-a-new-class-of-analgesics/

  • Lea says:

    Is there any doubt that, if cannabidiol were a derivative of any other plant, it would have been approved for use long ago?
    and
    Everyone asks what marijuana does, but no one ever asks what marijuana prohibition does. Perhaps they don't want to know.
    I take issue with your wording: "First, we know from anecdotes accessible to nearly everyone who has come across a dope smoker".
    Maybe you were singling out this person you spoke of in this article however, it was a poor assessment. As with everything in life there's going to be one easy target to align with. Your arguments are weak and completely biased.

  • kai says:

    Actually the simplest solution would be for CA to buy some cigarette manufacturing equipment, set it up somewhere and use all of the copious amounts of seized marijuana to make joints for distribution through the local pharmacies.

    Is smoking the marijuana indeed the most effective method of supplying the active substances? It seems paradoxical to me that one would for a medicine use a delivery method that is so obviously unhealthy. (Even if the target population would be all terminal patients anyway.)
    I don't quite understand why the marijuana can't be treated as other controlled substances that have medical use: have it grown under controlled circumstances by properly licensed growers and going through a quality-controlled pharmaceutical process. Certainly medically-used morphine (for example) isn't made from stuff smuggled into the country and grown who knows where?

  • MattXIV says:

    kai,

    Is smoking the marijuana indeed the most effective method of supplying the active substances? It seems paradoxical to me that one would for a medicine use a delivery method that is so obviously unhealthy. (Even if the target population would be all terminal patients anyway.)

    Smoking gets used for a few reasons related to adsorbtion through the lungs vs other methods. It's quick acting and this allows it to be adjusted the approprate level of response by the user. Cannabiniods aren't that effeciently absorbed through the GI system, so it's more effecient if you don't have a lot of material to work with. Nausea is also an issue in a lot of the patients, so (this is also why dramamine comes in a suppository form - pills aren't any good if you can't keep them down).
    These aren't insurmountable problems - vaporizers that heat the material enough to sublimate the cannabinoids without burning the material and creating tars can be used and even see some use among recreational users, although their use is limited by their expense, bulkiness and requirement for a power source. An inhaler that containted the compounds of interest in an appropriate biocompatible solvent would also work - that shouldn't actually be that difficult to get approved with 's status, but

    don't quite understand why the marijuana can't be treated as other controlled substances that have medical use: have it grown under controlled circumstances by properly licensed growers and going through a quality-controlled pharmaceutical process.

    It's on Schedule I, meaning there's no accpeted medical use as far as the feds are concerned. There is very limited legal federally-regulated production for research purposes, but it is nearly impossible to gain access to. All growing under the state programs is considered illegal by the Justice Department and may or may not get raided depending what the AG's priorities are. Also, as noted above, the state laws often don't have very well though-out ideas for how it's actually going to end up produced. Normal pharmacetical manufacturers and distributors won't touch it with a 10' pole because of it's messy legal status.

  • DrugMonkey says:

    juniorprof....great post! go read, everyone.
    Maybe you were singling out this person you spoke of in this article however, it was a poor assessment. As with everything in life there's going to be one easy target to align with. Your arguments are weak and completely biased.
    Lea, perhaps I am particularly dense this morning but if you expect a discussion you are going to have to be a little more specific.
    Is smoking the marijuana indeed the most effective method of supplying the active substances?
    kai, first, see comments #6, #7 and read juniorprof's post linked at #9, that will help. apart from the development of non-euphoric pain-controlling cannabinoids, it all depends what you mean by "most effective". Many medical marijuana patients swear up, down and sideways that the oral THC medication (Marinol/dronabinal) is less effective than smoking cannabis. Even if we assume that delta9-THC is the sole active ingredient in cannabis (it isn't) there are plenty of reasons to believe in differences based on pharmacokinetics- how rapidly a dose reaches the various receptors (i.e., both intended active locations and those which might be described as subserving side effects in this context), in what magnitude, how long peak levels are sustained, etc. Smoking has a tendency to give users both rapid exposure and very good control over the dosing on essentially a minute by minute basis. There are people (as always, start with MAPS) pursuing vaporizing inhaling devices to attempt to get the benefits of inhaled dosing without so many drawbacks of smoking.
    Then, because we are talking realities of public health there are questions about the expense and ready availability of the cannabis versus Marinol.
    I don't quite understand why the marijuana can't be treated as other controlled substances that have medical use: have it grown under controlled circumstances by properly licensed growers and going through a quality-controlled pharmaceutical process.
    It is, actually. There is a single contractor that grows marijuana for federal purposes, including NIH-funded research and a bare handful of patients. The contractor is supposed to assess the crops for content in several ways, going by my memory of the last RFA that was put out asking for competing applications. actually there is a very interesting story here and just about everyone in research using this stuff that I've talked with agree with the patient advocates that the resulting marijuana is considerably below par. according to their research volunteers, of course. guess who? is also trying to force the DEA to permit an effort to research the production of better marijuana and to open this process up to better competition. despite the periodic competition for the contract, one location has been the only awardee over decades as far as I know.

  • DuWayne says:

    kai -
    Actually, a lot of medi-marijuana users either use a vaporizer or ingest it (usually cooked into something). There are a lot of people who use it who can't actually smoke it at all, this is especially common with people who have full blown AIDS. Vaporizers are pretty common because ingesting cannabinoids doesn't seem to stimulate the appetite as much as vaporized (smoking it also vaporizes them) cannabinoids. OTOH, I personally wonder if ingesting them might not be a more effective delivery for the analgesic properties. I would certainly think that it would extend the duration of it's effectiveness.

  • juniorprof says:

    Kai and DuWayne,
    As DM notes, there are a whole host of compounds in cooked, smoked or whatever marijuana prep you wanna look at that you just don't get in marinol. A good number of these "extras" have analgesic activity and the mechanisms of action do not neccessarily involve cannabinoid receptors. I'm not sure about any actual clinical trials for marinol for pain; however, in some of the pain clinics I have noted that the docs think marinol isn't worth a darn for pain control (almost certainly because it has "difficult" PK/PD).

  • DrugMonkey says:

    I personally wonder if ingesting them might not be a more effective delivery for the analgesic properties. I would certainly think that it would extend the duration of it's effectiveness.
    In a generic sense yes but you have to remember that you are changing the duration of effectiveness for side effects too. And there is no guarantee every effect of a drug follows a similar timecourse. So you may change the balance of therapeutic/side effects from acceptable to unacceptable.
    And even with the one intended therapeutic indication.... Suppose you have a rapid onset route of administration. Generically, you can probably expose the entire system to less drug to get a high peak effect if this is the requirement. Even unmedicated pain ebbs and flows depending on what someone is doing, no? Trying to get to sleep? You might just need to knock off the edge enough to fall asleep. Workday versus weekend? Well, you might be able to tolerate different levels of pain depending on what you had to do, your responsibilities, etc. What I'm getting at is that in some scenarios a very rapid and relatively minimal dose might suffice-something you might not be able to pull off with oral administration of the drug no matter how tricky your formulation technology.

  • DuWayne says:

    Oy, I should also note that I base my assertions above on personal experience and the anecdotes of others.
    But given that understanding, I should explain that smoking most any drug will have a stronger overt effect (i.e. a stronger "high") but those effects have a much shorter duration than ingesting the drug will provide. b

  • DrugMonkey says:

    I base my assertions above on personal experience and the anecdotes of others.
    It is no coincidence that the best place to start the route-of-admin / PK story in a drug abuse class for undergraduates is with the bong / pot brownies example..... 🙂

  • DuWayne says:

    JuniorProf -
    The only people I know of who take marinol, take it for nausea and appetite. And they only take that because they can get it down easier in the morning, than they can any form of marijuana. Both of them are well along with full blown AIDS. Another person I knew who did much the same took advantage of Oregon's death with dignity act, last fall. (I didn't know him well, I started reading his blog when he was living in LA.)
    DM -
    I actually had a job to do today that was only about twenty blocks from a medical marijuana grower I am friends with. He's HIV positive and owns a bunch of properties, including one that he uses for a cooperative growing location, utilyzed by several "care givers" (Legal to grow for themselves and others in Oregon). They are apparently legally entitled to get a minimal payment for the service of growing for those who can't do so themselves.
    What he told me pretty well meshed with your discussion of differing methods of administering the marijuana. He said they actually turn better than half of what's grown there into hash, which they form into pellets that can either be swallowed, smoked, vaporized, cooked with, put into a suppository form or put in a capsule for easier swallowing. The vast majority of the patients who are served out of his coop are HIV, AIDS and cancer victims. Most of the individuals who are in advanced stages of their disease stop smoking it (if they ever did, many don't) and further along most of them end up giving up their vaporizers.
    But he said that as long as they can handle it, most of them either smoke or use a vaporizer for quick relief. Apparently after they can no longer use even a vaporizer the preferred method for quicker relief is using a suppository.
    It is no coincidence that the best place to start the route-of-admin / PK story in a drug abuse class for undergraduates is with the bong / pot brownies example..... 🙂
    Bongs and brownies are a dangerous combination. Especially if the brownies are made right. I once made a massive batch of rather strong brownies and was taking bong tokes during the whole process. By the time the brownies were done, I was so very stoned and they smelled so very good - well, lets just say that I took rather a bit less brownies to the party I had made them for than I intended. I was, shall we say, really fucking stoned. Had a gig that night and went totally Neil Young with my lyrics (ie I mostly made it up as I went along, even for songs that I not only knew, but wrote).

  • R. Schauer says:

    So let me get this straight...we have a PLANT that has grown for, oh, say 10,000 years give or take. It has grown largely unregulated until the 1930s or so. Then it was grown for its rope making qualities during WW2 and re-regulated after a period of time. During the time it was unregulated people used it for various reasons both medicinally and economic/mechanical.
    It was unobserved that people were generally harmed or injured during those times of legalization and it proved somewhat beneficial to society. Now we have storm-troopers that arrest and jail growers and users resulting in limited medicinal use and zero or negative economic impact due to loss of wages and costs of incarceration.
    Is any of this making sense to anyone? We have, in addition, lost a freedom and gained a potential for abuse by the authorities who have repeatedly demonstrated an incapacity for accountability and justice not to mention a passion for any intellectual acumen whatsoever. I guess enforecement of nonsense laws like this, in view of tragedies like Katrina, gives rise to my complete loss of faith in this country and the god that it is under. Anyway, thanks for the great blog!

  • drugmonkey says:

    ...my fondness for the Trojan Horse leegalizeeetmon types..

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