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“For Patients, By Patients”: Med-Pot, Lay-Experts and the Construction of Cultural Credibility
Lifestyle - Features
Written by Ændrew Rininsland   
Monday, 25 May 2009 23:20

Since the 1960s, two diametrically-opposed views of drug use have appeared.

The view represented by the government and medical establishment has largely regarded all drug usage outside the realm of the medical activity to be considered an abuse with a negative impact on society (Martel 59), while critical perspectives have argued that the rationale for using drugs cannot be reduced to mere abuse or addiction (60). Instead, many have argued that drugs are an intrinsic part of spiritual experiences (i) or can be used to expand and better understanding of the human condition (ii). Central to this discussion are concerns about the health of drug-using individuals, especially since the start of the modern War on Drugs in the 1970s.

Most notably with regards to the question of cannabis prohibition, professional experts have thus been employed in varying capacities by both sides in an attempt to discredit the other. Looking through the lens of these differing professional opinions, we can begin to see many of the socio-political factors contributing to a public “credibility gap” in contemporary discussions on both the legalization and medicinal use of cannabis. As a result of this “credibility gap,” critical voices may emerge from non-professional bodies (Epstein 411).

It is in constructing a base of “lay-experts” willing to debate the effects of cannabis on health while simultaneously using the language of expert and professional bodies that medicinal cannabis advocacy groups are achieving a degree of credibility on an issue that in the past has largely been restricted to professional and government discussions.

Prohibition before the ’70s — From Bootleggers to Hippies

The 20th century is marked by multiple failed attempts by North American governments to control the use of psychotropic drugs. This is not a mere matter of opinion: from any objective perspective, attempts to prohibit the use of drugs have failed miserably, both in achieving their original intent and exacerbating a host of social, political and culture problems.

Beginning with opium prohibition in 1914 in the U.S., North American governments have taken an essentially reactionary approach to drug use and abuse (Whitebread 1995). Though a comprehensive analysis of all these policies and why they can be considered failures is far beyond the scope of this paper, two examples may perhaps serve to illustrate why this is so, and also to facilitate understanding of the public reaction to the Nixon-era Drug War. In this short historical outline of alcohol and cannabis prohibition, I hope to demonstrate that the original decision to regulate cannabis was based on racism and public pressure — not professional advice. With the advent of the War on Drugs and the change of focus to the personal health effects of cannabis, the conflicting professional opinions allowed space for critical discourses to appear and allowed the lay-expert advancement of the medicinal cannabis movement.

According to Dills, Jacobson and Miron, “[Alcohol] prohibition had a substantial short-term effect but roughly a zero longer-term effect on drunkenness arrests” (4).  They then go on to compare cirrhosis rates (The other indicator often used to determine the effectiveness of alcohol prohibition) to find similar implied behaviours, leading the authors to conclude that alcohol prohibition had a limited effect on national consumption (4). However, along with having no long-term effect on alcohol consumption, alcohol prohibition also had very negative social consequences as well. By putting distribution and sale of alcohol into the hands of organized crime, gangsters such as Al Capone and Johnny Torrio were able to amass much wealth and power, resulting in not only empowering the Mafia but also much violence (Whitebread 1995). (iii)

By the 1930s, the social consequences of alcohol prohibition were becoming much too great and the government ended it (Whitebread 1995). However, in an act of what can only be considered incredible irony, the government would embark upon a new and equally disastrous but much more long-lived attempt to control public use of psychotropics—less than half a decade after the fall of alcohol prohibition. The 1937 Marihuana Tax Act in the United States was passed largely as a result of racism towards Mexican migrant workers and black jazz musicians — for an example demonstrating the validity of this, one only need to look at Federal Bureau of Narcotics Chief Harry Anslinger’s testimony at a 1948 Senate hearing where he was requesting more agents to pursue drug law violations. When asked who was violating marijuana laws, he told the committee that “musicians” were the culprit: “And I don’t mean good musicians — I mean jazz musicians.” (1995)

My point in this is that the regulation of cannabis was never initially about the effects of it on the health of individuals. When the government first sought to regulate cannabis in 1937, Chief Counsel to the American Medical Association Dr. William C. Woodward testified by saying “The American Medical Association knows of no evidence that marijuana is a dangerous drug” — however, his opinion was promptly disregarded and cannabis was prohibited anyway, with one of the bill’s proponents outright lying about Woodward’s position (Whitebread 1995). The only other piece of medical testimony was given by a researcher now believed to have been falsifying his results (1995).

Cannabis prohibition in Canada followed a similar policy arc to that of the United States, though it preceded it by over a decade. There are two theories for why this is so. Many argue that the 1922 publication of Emily Murphy’s The Black Candle was one of the driving factors for adding cannabis to the Confidential Restricted List (Canada’s precursor to the U.N. Single International Convention on Narcotic Drugs’ schedule system), while Carstairs argues that Canada’s inclusion in several League of Nations-sponsored narcotics conventions was more instrumental in shaping this policy (31). Regardless, it took until the 1960s for law enforcement to begin paying any attention to cannabis—between 1946 and 1961, it was involved in only two per cent of all drug arrests (112).

By the mid-’60s, the legalization of cannabis had become a much larger social issue than it had in the past. The proliferation of cannabis in the U.S. and its migration north to Canada resulted in an increased acceptance by youth (Leading one studier of high school drug use rates to dourly conclude that the entire continent would be smoking it within a decade given adoption rates in the early ’70s.), and also an increased crackdown by law enforcement (Martel 30; Spicer 2002). The debate was fully-formed in Canada by the 1970s, to such a point that the government question legalizing it for the first time since its prohibition in 1923.

1970 to 2009 — The War On Drugs

The government’s constantly changing rationale for criminalizing cannabis users reached a head in 1972 when U.S. President Nixon launched the War On Drugs. Once demonized for allegedly causing violence amongst minorities, then demonized as a tool used by Communist Russia to turn American youths into pacifists at the height of the Cold War, Nixon’s launching of the War on Drugs thus aimed to end illicit drug use in the United States using methodology for once more dependent upon expert opinion than the more racist and paranoid rhetoric of the early “Reefer Madness” years (Whitebread 1995). In 1972, Nixon created the Shafer Commission to investigate the harm of cannabis use, which concluded that marijuana should be decriminalized (Shafer 1972). It largely argued that cannabis use was no more a danger than alcohol use and it was likely unconstitutional to enforce its ban federally (1972). Nixon rejected these findings and the trend for the next two decades became that an incredible amount of conflicting information was given to the media, forcing the public to come to their own conclusions regarding cannabis.

On one hand, a lot of very poor research was done. A good example of this is the 1977 study “Effects of Cannabis Sativa on Ultrastructure of the Synapse in Monkey Brain” by J.W. Harper and R.G. Heath, followed by Heath’s other two studies, “Chronic Marijuana Smoking: Its effects on Function and Structure of the Primate Brain” (1979) and “Cannabis Sativa Effects on Brain Function and Ultrastructure in Rhesus Monkeys” (1980). These echoed the now-familiar paranoia about the alleged brain damage potential of cannabis, but also supposedly backed it up with medical analysis. The result was the widely-distributed government anti-cannabis “This is your brain on drugs” campaign, wherein those who frequently use the drug are engaging in an act compared by the commercial to cracking their heads open and frying their brains on a skillet, and “any questions” had to be deferred until these assertions were refuted (often only in the scientific press) by other experts. Such was the case when 1970 Nobel Prize Winner Julius Axelrod investigated the study further, only to realize that the method used by Heath et al was essentially asphyxiating the rhesus monkeys being studied. (iv) Other government-initiated and independent multinational studies (Including the Le Dain Commission, Canada’s version of the U.S. Shafer Commission) have indicated that smoking cannabis is no more harmful than drinking, and likely much less harmful than smoking cigarettes (Le Dain 1972). For instance, at least one study discovered that Delta-9 Tetrahydrocannabinol (THC, the main psychoactive component in cannabis) potentially even has retrocarcinogenic properties, a finding that correlates to an earlier study in the ’80s that found cannabis-smoking patrons of “compassion clubs” in San Francisco had no higher incidence rates of emphysema or lung cancer than the non-smoking control group (National Toxicology Program 1996; Vinciguerra 1988). This contradicts other work with relation to the effects of cannabis on the respiratory system, the most recent of which states the tar output of a single joint is about fives that of an equivalent-sized tobacco cigarette (Aldington 2007).

A few factors had an impact on the professional discussion. The U.S. Drug Enforcement Agency has the ability to block research proposals dealing with scheduled substances, causing a continued federal monopoly on cannabis research (Canadian AIDS Society 43). Because of prohibition, the presence of a law enforcement body in what should be essentially a medical discussion clouds matters greatly; how much research has been adversely affected by their involvement is anyone’s guess. The social stigmatization of cannabis users and their association with bohemian culture also likely has had an effect with regards to doing serious research on the topic (41; 45). As well, because the psychoactive ingredients in cannabis are naturally occurring (And thus not patentable), their potential for commercialization is limited.

Meanwhile, to add further confusion, the 1980s brought forth the medicinal argument to the broader discussion of cannabis prohibition in North America. Not only were expert opinions about the health impacts of cannabis contradictory, but here we see also the emergence of a group with the belief that this much-maligned drug can actually be therapeutic. It’s not really a new belief; cannabis has been used by herbalists for millennia and has been proscribed for everything from failing eyesight to erectile dysfunction (Spicer 2002). In fact, cannabis even existed in the pharmacopoeia of the U.S. from 1850 until 1942. Statements by various government officials seem to back this up: in 1988, U.S. Drug Enforcement Agency (DEA) administrative law judge Francis L. Young noted that “in its natural form, [cannabis] is one of the safest therapeutically active substances known,” and the 1972 Canadian Le Dain commission reached similar conclusions (Young 1988; LeDain 1972).  Further, the 1978 creation of the U.S. Compassionate Investigational New Drug program, in which the government supplied cannabis to a group of people who exhibited clear medical necessity, seems to acknowledge its medicinal benefit (“U.S. v. Randall” 1976). Yet at the same time, cannabis has always existed as a Schedule I drug in the United States, implying it has no medicinal benefit whatsoever (DEA 2002). To this day, even though one in four Americans now live in a state where medical marijuana initiatives have been passed via referendum, this classification has allowed federal police to invade otherwise law-abiding clinics in the same way they would a drug kingpin’s house. As such, with such clear contradictions between government policy and action, citizens were forced to form their opinions about cannabis use outside the confused opinions of established science and medicine.

Suffice to say, by the mid-1990s, the public was in a state of confusion about not only the legal state of cannabis, but also the effects of smoking it on the body. Further international medical research by independent groups also contributed to arguments on both sides of the discussion. In particular, the emergence of Californian medicinal marijuana dispensaries (“Compassion Clubs”) initially designed to care for AIDS patients in the San Francisco area and extended via Proposition 215 contributed to public discussion on this topic (“Proposition 215” 1996). The emergence of the AIDS epidemic in the 1980s was a factor aiding the public discourse on medicinal cannabis as the so-called “munchies”—the occasional cravings for food that are more often than not a nuisance for cannabis smokers—was found to be in fact quite an effective method for combating wasting syndrome in HIV/AIDS patients (Haney et al 2005). The establishment of a federal medicinal cannabis program in Canada in the late ’90s furthered the medicinal argument as well (Health Canada 2009). Meanwhile, cannabis remained an illegal drug with far harsher penalties for possession than prescription drugs. Further, patients have had (and continue) to go through a long and difficult process in order to get a medical marijuana exemption, exasperated by differing regional regulations towards medicinal usage, cannabis’ continued status as a Schedule 1 drug in the U.S. (As well as the closing of that’s country’s federal medicinal program), and very limited and poor program implementation in Canada. Into this environment, the modern citizen-driven medicinal cannabis movement emerged.

Where we are now: the 21st century

Medicinal cannabis has always been a citizen-driven movement. Both the creation of the incredibly-guarded and now-defunct U.S. Compassionate Investigational New Drug program and the modern Health Canada system resulted from medical necessity cases brought before each country’s respective Supreme Courts by patients (“Randall v. U.S.” 1975; “R. v. Parker” 2000). Above I have outlined some of the difficulties in creating a scientific consensus towards the health effects of cannabis use and the resulting legislative schizophrenia that ensued. The resulting loss in scientific credibility thus has forced a unique cooperation between activists, scientific experts and citizens at large. According to Starr in Epstein, “[scientific] authority ... includes not just social authority rooted in a division of labour or in organizational hierarchies ... but also cultural authority, which rests on the actor’s capacity to offer what is taken to be truth” (Epstein 411). Scientific authority becomes questioned with the creation of what Epstein calls a “credibility gap,” wherein the failure of experts to quickly solve a problem not only increases popular resentment of experts, but also diminishes the credibility of the medical establishment while simultaneously creating space for critical opinions (411). In this the press played a fundamental role, in communicating both expert opinion and expanding the discussion to social and political contexts. However, it has been a combination of specialty media, activist organizations and increased communication technology that have contributed the most interesting critical discourses.

In his discussion of how the HIV/AIDS community contributed to the global discussion about clinical trials through the construction of lay expertise, Steven Epstein analyzes how AIDS activists have established medical credibility and how their particular knowledge effects the broader discourse. Using the tools of identity politics established by the gay rights and female health movements, AIDS activists were able to gain credibility to the scientific establishment and thus act as lay-experts (Epstein 415). He notes four ways in which these non-expert groups were able to gain credibility: through the acquisition of cultural competence, establishment of political representation, the combination of epistemological and ethical claims-making and taking sides in pre-existing methodological disputes (410). In many ways, the modern medicinal cannabis movement is enormously similar, both in its composition and execution. It too is comprised of members of the “new middle-class” with a lot of cultural capital (414; NORML, “Who Are You?” 2009); as well, it has begun an extensive project to create cultural competence by adopting the vocabulary of the professionals they are engaging with. New political representation is forming, and the multifarious reach of the issue — into discourses as varied as environmentalism (As Hemp, cannabis’ much-maligned and equally-contraindicated non-psychoactive relative would be an ideal biofuel)(Reason 2008) and criminal justice — not only facilitates, but requires, side-taking in professional discussions. And, as an issue that crosses all gender, race and class lines, the opponents of the War on Drugs need only point to the massive number of incarcerated non-violent drug offenders to argue not only the importance of ethical and epistemological claims-making, but the moral necessity of it.

The so-called “Cannabis Media” originates in some capacity with the founding of High Times in 1974 by Tom Forcade (Nocenti 2004). Originally started as a lifestyle magazine fashioned after Playboy, High Times quickly became one of the few periodicals printing a wide range of scientific opinion and commentary on the topic of cannabis. On one hand, by publishing the gamut of medical and government literature on the topic of cannabis to a broader audience, more obscure expert literature ignored by the mainstream press was communicable to a non-expert mass.  The success of High Times spawned several competitors: Skunk Magazine and 420 Magazine in the U.S.; Cannabis Culture and Treating Yourself in Canada; Weed World in the United Kingdom, among others. Without dwelling on the particulars of any of these periodicals, the mere presence of a specific, distributed publishing market relating to this topic is interesting of itself. The fact many of these periodicals utilize decentralized Internet-based production models reliant on heavy community involvement is even more so. In this way, by involving larger publics and civil society organizations such as activist groups in this publishing process, non-expert and non-governmental actors are allowed to contribute to the dissemination of critiques of the existing discussion relating to government control of cannabis. As a social movement, proponents of cannabis legalization (whether generally or for medicinal purposes) have been able to aid in the construction of social meanings and forms of knowledge like few others in history and it is perhaps at least partially because of this that support for cannabis legalization has surged to 44 per cent nationally in the U.S. in recent months (NORML 2009).

In his discussion of HIV/AIDS activists, Epstein notes “The most crucial avenue pursued by treatment activists in the construction of their scientific credibility has been precisely the acquisition of such competence by learning the language and culture of medical science” (417). However, unlike the AIDS activists studied by Epstein, the cannabis legalization movement has access to a resource quite unique to its historical era — the Internet. As such, an incredibly wide range of resources is now available to an independent researcher wishing to pursue an explorative literature analysis of existing medical sources. In the ’70s and ’80s, a comprehensive literature review of a topic such as the effects of cannabis on ADHD would have been impossible due to an incredibly limited amount of existing research, but also due to greater constraints on access to physical media. The ability of lay-experts to construct evidence to their claims using the language and data of the medical establishment was severely limited due to the arcane nature of medical journals — short of having access to a medical library or having a subscription to a host of medical journals, constructing authoritative literature reviews was next to impossible for non-experts. With the advent of online journal databases and services such as Google Scholar, however, a simple text query can be used to locate an enormous wealth of obscure and arcane academic information. The result of this is an intrinsic movement towards using professional language — one might be quite surprised while looking through the pages of Treating Yourself and find them devoid of the language “stoners” are usually stereotyped with, largely as a result of this emphasis on expert communication. It is worth noting given that it indicates this shift in the discussion surrounding cannabis usage.  These aforementioned activist efforts — groups such as the U.S.-based National Organization for the Reform of Marijuana Laws (NORML) and Law Enforcement Against Prohibition (LEAP) — also play a part in communicating expert literature to non-expert groups, who in turn adopt the language in communicating movement ideas to the broader public. Further, compared to a few years ago, there are now no less than three online cannabis news aggregators (420.com, Stopthedrugwar.org and Hotbox's project, Smokkr.com), allowing an editorial piece about medicinal cannabis in a small Australian newspaper to be propagated to dozens of different websites across the globe instantaneously. This has the effect of allowing members of the community to respond immediately to factually inaccurate articles (Thus simultaneously reifying the epistemological basis of pro-cannabis arguments and undermining the validity of disputed expert literature), while also creating an enormous wealth of easily searchable and very topical information for those doing research. The result is that while the medicinal cannabis movement and the cannabis legalization movement have different aims (The former often being more conservative and only wishing to legalize for medical reasons and the latter advocating for legal sales and use by the general public, though there is often overlap), their use of similar expert literature in arguing similar points allows both movements greater cultural credibility through shared professionalization of the language of the discourse itself.

The second way in which lay-experts achieve cultural credibility is through established representation. Epstein refers to this as a “credibility achievement” insomuch that it shows activists have sufficiently organized themselves in a capacity where they can argue that they are the voice of a specific group (Epstein 419). Medicinal cannabis patients have done this through representative advocacy groups such as NORML and LEAP, which have been instrumental in current legislative challenges with regards to medicinal cannabis. 13 U.S. states (Alaska, California, Colorado, Hawaii, Maine, Michigan, Montana, Nevada, Oregon, Rhode Island, Vermont and Washing) have made some kind of exemption for medicinal cannabis, with Arizona and Maryland both having sympathetic legislation (“Active State Medical Marijuana Programs” 2009). These are all contemporary political events, with the first state to pass pro-medicinal cannabis legislation being California in 1996. Further, it was NORML that provided professional support to patients during the initial U.S. federal cases arguing their necessity for medicinal cannabis.  While patients taking an intelligent and proactive role in the decision making process were crucial to this legislation being passed, the actions of advocacy groups such as NORML and LEAP had effects as well. First, they galvanized the community through proliferating related news and studies. While the cannabis media is beginning to show signs of both an external and internal battle for credibility, groups such as NORML and LEAP were founded with the intent to promote alternatives to existing drug policies, with an empirical edge from the outset. In particular, NORML has funded a significant amount of cannabis research, with results supporting a range of arguments: from the more general (Analyzing U.S. Substance Abuse and Mental Health Data Archive figures in order to ascertain cannabis user demographic data) to the highly political (Measuring and collecting drug-related sentences as defined by racial demographics) to ones focused more on the medical discussion (Particulate analysis to determine whether joints, pipes, bongs or vaporizers are the healthiest smoking method). In doing so, members of advocacy groups such as NORML straddle the line between lay-experts and professional researchers while also providing new data to lay-experts pursuing the argument. Most importantly, however, groups such as NORML indicate a growing political representation on behalf of cannabis users. After U.S. President Obama’s online “Town Hall” meeting — where Internet surfers were asked to submit personal questions for Obama to be answered, resulting in cannabis-related questions receiving enough votes to occupy 8 of the top 15 questions and a snub from the President — groups such as NORML received a massive surge in funding, causing a chain reaction wherein many mainstream media outlets began publishing OpEd pieces about the topic of general cannabis legalization (“Fundraising jump” 2009). The resulting response has since fueled even more discussion — as an example, my Smokkr project has seen a 15-fold increase in the number of links relating to OpEd pieces mentioning legalization when comparing the periods from September 1 to December 31, 2008 and January 1 to April 30, 2009. The result is that these advocacy bodies are able to relate their message to a far greater population and thus drive popular support, eventually leading to even greater potential for political adoption by elected politicians. Because advocacy groups such as NORML are seen to be representative, established politicians and members of civil society such as the media often contact them. This in turn gives lay-experts more cultural credibility, especially when presenting findings under the aegis of a national organization. Naturally, it also increases the larger public awareness of the issue (And thus facilitating a need for experts to drive public understanding, whether lay- or not) when media consults these organizations.

According to Epstein, “A third credibility tactic employed by treatment activists consisted of yoking together methodological (or epistemological) arguments and moral (or political) arguments so as to monopolize different forms of credibility in different domains” (Epstein 420). He gives the example of clinical trials with AIDS patients, wherein the initial subject populations consisted largely of middle-class white men. Treatment activists thus argued trials should more accurately reflect the demographics afflicted by HIV/AIDS and thus all affected populations must be given access to the trials (420). “Activists therefore pushed simultaneously for a morally credible policy promoting fair access to experimental drugs and for a scientifically credible policy for acquiring generalizable data,” in short giving this representative activist body both the moral and scientific high-ground (421). In much the same way, the medicinal cannabis community uses two strains of arguments. On the epistemological end, it argues that cannabis has far fewer side effects than most of the prescription medications available on the market, and is fundamentally harder to overdose on given the incredibly enormous LD-50 of THC. Many in the medicinal community regard the scheduled nature of cannabis as ludicrous: in Treating Yourself issue 10, writer Wendal Grant compares the enormous and incredibly daunting list of side-effects for the pharmaceuticals prescribed by her doctors, with the comparatively-harmless effects of cannabis (Grant 2007). From this emerges the moral claim medicinal cannabis users are able to make: given that the professional consensus is perceived to have a “credibility gap” while simultaneously claiming that a plant with no overdose or physical addiction potential and incredibly benign side-effects is an enormously harmful drug (even while the patient is experiencing relief from it), the patient is forced into a moral quandary. He or she is thus forced to either violate professional opinion and the law itself in order to obtain the relief sought, or take a cocktail of potentially-harmful pharmaceuticals, with often additional pharmaceuticals needed to counter the side-effects of the first, which may not even offer the same relief as cannabis. Thus, as claim-makers with regards to their own personal health, medicinal cannabis patients are thus able to morally argue that it should be their decision as to how they medicate — not the government.

Lastly, much like the AIDS treatment activists mentioned by Epstein, medicinal cannabis patients often take sides in pre-existing professional debates (421). This can be seen in community response to findings — as an example, when a New Zealand research lab released findings displaying levels of psychosis in cannabis users, a member of the Treating Yourself community going by the Internet alias of “pflover” (“pf,” of course, standing for “Pink Floyd”) produced a massive literature review of various psychosis factors for publication in the _ issue. At once, pflover sided with creators of the study in approving their methodology, while at the same time expanding on their findings and disagreeing with their conclusion (pflover 2007). While the media was relaying the findings as indicating cannabis users were more prone to psychosis, pflover’s analysis demonstrated that, compared to many other common environmental factors, cannabis usage had a comparatively minor effect (18). This at once validated one set of professional opinions (i.e., in terms of methodology) and sought to clarify public understanding of findings while using language understandable by both a public and professional audience.  Contributions on behalf of lay-experts in the medicinal cannabis community give scope to professional findings while contributing both localized knowledge and stakeholder opinion to a broader expert discourse on the topic.

Conclusion: We only know what we know

In the preceding paper I have done essentially two things: first, I discussed the socio-political events which aided in the widespread public confusion with regards to the health effects of cannabis, before then beginning a discussion of how a combination of lay-experts, specialty media and advocacy groups in forming North American perceptions of medicinal cannabis usage. While the general discussion of cannabis legalization inevitably overlaps with the medicinal at points, I have endeavored to isolate the elements specific to the medicinal cannabis movement so as to better illustrate the large number of lay-experts involved with that group. In doing so, I hope to have demonstrated the enormous potential of both the general legalization and medicinal cannabis communities for both advancing discourses on drug policy and patient use of drugs, but also in finally ending the expensive and ineffective prohibition of cannabis for good.

Works Cited:

"Active State Medical Marijuana Programs." 01 Dec 2004. NORML. 4 May 2009 .

Aldington, S. "Effects of cannabis on pulmonary structure, function and symptoms." Thorax 62(2007): 1058-63. Print.

Belville, Russ. "Who Are You? US Government Statistics on Adult Marijuana Users." 10 Apr 2009. NORML. 4 May 2009 .

"Cannabis as Therapy for People Living with HIV/AIDS: “Our Right, Our Choice”." 06 July 2006. Canadian AIDS Society. 4 May 2009 .

Dills, Angela K. "The Effect of Alcohol Prohibition on Alcohol Consumption: Evidence from Drunkenness Arrests." Working paper. 4 May 2009 .

Epstein, Steven. "The Construction of Lay Expertise: AIDS Activism and the Forging of Credibility in the Reform of Clinical Trials." Science, Technology, & Human Values 20(1995): 408-437. Print.

"Frequently Asked Questions: Medical Marijuana." 13 July 2005. Health Canada. 4 May 2009 .

Grant, Wendal. "The Side Effects of Pharmaceutical Drugs." Treating Yourself 10(2007): 45-47. Print.

Hamby, Peter. "Fundraising jump for marijuana group after Obama snub." CNN Political Ticker. 28 Mar 2009. CNN. 4 May 2009 .

Haney, M, Rabkin, J, Gunderson, E, and Foltin, RW. “Dronabinol and marijuana in HIV(+) marijuana smokers: acute effects on caloric intake and mood.” Psychopharmacology 1(2005): 170-8. Print.

Heath, R.G., A.T. Fitzjarrell, and C.J. Fontana. "Cannabis sativa: effects on brain function and ultrastructure in rhesus monkeys." Biological Psychiatry 15(1980): 657-90. Print.

Heath, R.G., Fitzjarrell, A.T., Garey, R.E., Myers, W.A. Chronic Marijuana Smoking: Its effects on Function and Structure of the Primate Brain, Marijuana Biological Effects. Oxford, England, Plenum, 1979.

Heath, R.G., Harper, J.W. and Myers, W.A. "Effects of Cannabis sativa on ultrastructure of the synapse in monkey brain." Journal of Neuroscience Research 3(1977): 87-93. Print.

Le Dain, Gerald. "The Report of the Canadian Government Commission of Inquiry into the Non-Medical Use of Drugs." Schaffer Library of Drug Policy. 1972. DRCNet. 4 May 2009 .

Martel, Marcel. Not This Time. 4. Toronto: University of Toronto Press, 2006. Print.

"Proposition 215: Text of Proposed Law." California Secretary of State. 4 May 2009 .

National Toxicology Program, "NTP Technical Report on the Toxicology and Carcinogenesis Studies of 1-Trans-Delta9-Tetrahyrdocannabinol (CAS No. 1972-08-3) in F344/N Rats and B6C3F1 Mice (Gavage Studies)." Schaffer Library of Drug Policy. Nov 1996. DRCNet. 4 May 2009 .

Nocenti, Annie. The High Times Reader. New York: Nation Books, 2004. Print.

pflover, "Insane in the Hemp-Brain?." Treating Yourself 10(2007): 18-29. Print.

"R. v. Parker." 08 Oct 1999. Ontario Courts. 4 May 2009 .

Shafer, R.P. "Marihuana: A Signal of Misunderstanding." Schaffer Library of Drug Policy. Mar 1972. DRCNet. 4 May 2009 .

Smith-Heisters, Skaidra. "Illegally Green: Environmental Costs of Hemp Prohibition." 13 Mar 2008. Reason Foundation. 4 May 2009 .

Spicer, Leah. "Historical and Cultural Uses of Cannabis and the Canadian 'Marijuana Clash'." Library of Parliament. 12 Apr 2002. Senate Special Committee On Illegal Drugs. 4 May 2009 .

U.S. Drug Enforcement Agency, "DEA, Title 21, Section 812." 01 Feb 2002. U.S. Department of Justice. 4 May 2009 .

"U.S. v. Randall." 24 Nov 1976. Drug Law Reporter. 4 May 2009 .

Vinciguerra, T. "The use of inhalation marijuana as an antiemetic for cancer chemotherapy." New York State Journal of Medicine Oct 1988 525-527. Web. 4 May 2009.

Whitebread, Charles. "The History of the Non-Medical Use of Drugs in the United States." Schaffer Library of Drug Policy. 1995. DRCNet. 1 May 2009 .

Young, Francis. "Marijuana Medical Rescheduling Petition." 06 Sep 1988. Family Council on Drug Awareness. 4 May 2009 .

"Zogby Poll: Nearly Six Out Of Ten West Coast Voters Support Taxing And Regulating Marijuana Like Alcohol National Support For Pot Legalization Grows To 44 Percent." 19 Feb 2009. NORML. 4 May 2009 .

Endnotes:

1: In particular, see Timothy Leary’s The Politics of Ecstasy. Page 44: “If you are serious about your religion, if you really wish to commit yourself to the spiritual quest, you must learn how to use psychochemicals. Drugs are the religion of the twenty-first century. Pursuing the religious life today without using psychedelic drugs is like studying astronomy with the naked eye because that's how they did it in the first century A.D., and besides telescopes are unnatural.”

2: Alexander Shulgin, the discoverer of MDMA, comments in PiHKAL: A Chemical Love Story: “I decided to devote whatever energies and skills I might possess to unraveling the nature of these tools for self-exposure. It has been said that wisdom is the ability to understand others; it is the understanding of yourself that is enlightenment. I had just found my learning path.”  (17)

3: This section essentially summarizes Charles Whitebread’s “The History of the Non-Medical Use of Drugs in the United States.” Whitebread is one of the most authoritative scholars on cannabis prohibition in the U.S. and his telling of history on the topic is amongst one of the most detailed and balanced I’ve read. Given that my thesis is more to demonstrate the effects of the medicinal cannabis movement in constructing regimes of lay-experts than to detail the intricacies of cannabis prohibition, Whitebread’s analysis will suffice.

4: Axelrod testified to the 1974 Senate Subcommittee to Investigate the Administration of The Internal Security Act and Other Internal Security Laws with regards to Heath’s study. He said: “I respect Dr. Heath; he is a fine neurologist, but the doses he has given for the acute effect, for example, would be equivalent to smoking a hundred marihuana cigarettes, a very heavy dose of marihuana. And the amount he has given for the chronic effect represents smoking 30 marihuana cigarettes 3 times a day for a period of 6 months.” See: http://www.archive.org/stream/marihuanahashish00unit/marihuanahashish00unit_djvu.txt

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