Medical Marijuana: Good Medicine?
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MARGARET WARNER: The strategy is the Clinton administration’s response to two recently passed state ballot initiatives in Arizona and California. The new state laws permit marijuana and other illegal drugs to be used for medical purposes.
But at a press conference today administration officials said federal anti-drug law overrides state law in this area. Among other steps they said workers in safety-sensitive areas who can be fired now if they test positive for drug use may not use the new state laws as justification for using drugs.
They also said that federal law enforcement officers may prosecute and sanction doctors who recommend or prescribe the drugs. We have two perspectives on today’s action. We begin with retired General Barry McCaffrey, director of the Office of National Drug Control Policy. Welcome, General.
GENERAL BARRY McCAFFREY (Ret.), Director, National Drug Control Policy: Good to be here.
MARGARET WARNER: Why is the administration trying to override these two laws that were passed by the voters in these two states?
GENERAL BARRY McCAFFREY: We’re concerned about two things. First, to protect the medical scientific process by which you bring safe and effective medicine to the American people, and that’s done through a very effective process of the National Institute of Health and the Federal Drug Administration, Food & Drug Administration. So we think that’s important to avoid thalidomide, laetrile, to not have popular referendums that decide medicines.
Now, the second thing we’re worried about is drug abuse. We’ve got 3.6 million Americans addicted. Drug use by youngsters is skyrocketing. We think this proposition in California and a similar one in Arizona that approved heroin and LSD are simply a disaster. We really don’t see it as a medical issue. It’s the quasi-legalization of drugs.
MARGARET WARNER: All right. Let’s look at the practical effect on some categories of workers and citizens. First of all, workers in safety-sensitive areas. Explain a little more how that’s going to work?
GENERAL BARRY McCAFFREY: Well, we brought together most of the departments of government from the Nuclear Regulatory Control Commission to the Department of Transportation, Treasury, Health and Human Services, you name it, so the communicated message was that if you’re a federal worker in either of these two states, or a contractor under this federal Drug Free Work Place Act, or you’re getting federal moneys, for example, safe and drug free schools. Schedule one drugs are still against the law. You can’t drive a bus, fly an airline, be a National Guard sergeant or perform surgery while on marijuana.
MARGARET WARNER: All right. What if, though, you work for a company like–I don’t want to name a company–but a manufacturing company that receives federal contracts, is that also, as far as you’re concerned, no one who works for a company like that could, if they were undergoing chemotherapy, say have marijuana recommended or use it.
GENERAL BARRY McCAFFREY: Well, again, let me also tell you that certainly Sec. Shalala and I and the President have absolute confidence in American doctors–we have the best medical establishment on the face of the earth–simply aren’t going to be using Schedule one drugs as a general rule. So we’ve also promised the American medical establishment we will keep the door open to examine under scientific medical process this drug or any other that’s alleged to have benefits. So there’s no question that we’ll continue to look at what marijuana is alleged to provide benefit for. But having said all that, Schedule one drugs are prohibited. They’re against the law, possession growing end use.
MARGARET WARNER: All right. And just explain Schedule one drugs are marijuana–
GENERAL BARRY McCAFFREY: Marijuana, heroin, LSD. Interestingly enough, Margaret, what isn’t prohibited–a Schedule two drug–would be cocaine and methamphetamines. They are both horrendously dangerous, but they are drugs that have medical benefits. So there’s no reason why a property like THC, which is a legal drug, the active ingredient in marijuana, can’t be moved to Schedule two.
MARGARET WARNER: All right. Now you brought up the doctors. And that’s the other sort of controversial area here. What are you–what is going to be the federal policy toward doctors who now are recommending to some of their patients on chemotherapy or AIDS patients, other categories, right now they’re recommending to them that they find a way to get marijuana and that they do use it to help with their treatment in these other areas?
GENERAL BARRY McCAFFREY: Well, what we need to underscore is that the American Medical Association, the California Medical Association, our distinguished former Surgeon General, C. Everett Koop, across the country the serious professional organizations of American medicine oppose these two propositions. And, indeed, today the AMA released a press release and stated they support what we’re doing. So I’m almost hesitant to get involved in an argument about the medical dimension to it because what concerns us is legalization of drugs and drug abuse.
MARGARET WARNER: All right. But let me read to you from this paper work that you all released today. And you said that you’re going to be sending a letter to all state medical boards and so on warning that–the letters will state unequivocally that the Drug Enforcement Agency, the administration will seek to revoke DEA registration of any physician who recommends or prescribes Schedule one controlled substances.
GENERAL BARRY McCAFFREY: Last year, Margaret, there were some 900 physicians did lose their ability to prescribe schedule drugs because of mis-application of the law. So there’s no question. The federal law is still operative. It’s not affected by the two state propositions.
MARGARET WARNER: But then how are so many doctors–we’ve seen them on television today–saying I do recommend to my patients that they use it. You obviously aren’t going after all doctors now. Is it going to be the same level of enforcement, or stepped up enforcement?
GENERAL BARRY McCAFFREY: I don’t think the strategy, first of all, is not aimed–it doesn’t have a punitive basis to it, and to the extent that it does, it’s not aimed at any one profession. We’re saying to all Americans that if you have the public safety of the American people in your hands, don’t use Schedule one drugs. And, oh, by the way, they’re not a legal medicine.
MARGARET WARNER: What are you saying to doctors who say in their medical judgment they have certain patients that other therapies cannot work for and that their own medical judgment, their own ethics tell them I should recommend they find marijuana and use it to help them with this?
GENERAL BARRY McCAFFREY: I would urge them to listen to the judgment of the American Medical Association and to listen to the viewpoint of the National Institute of Health and the FDA and don’t use the Schedule one drugs. They’re dangerous, and they’re alleged by medical authorities to not have a benefit. So that’s really what we’re saying.
MARGARET WARNER: In other words, they do run the risk of prosecution?
GENERAL BARRY McCAFFREY: Absolutely. Or of losing their registration to prescribe drugs.
MARGARET WARNER: All right. Thank you, General.