As research and anecdotal evidence increasingly indicate cannabis has medical benefits, a new series of videos from a man suffering from Parkinsons disease highlights just how vital the plant can be.
Larry Smith, a former police officer, began to suffer from the debilitating neurological disease twenty years ago. In 2011, filmmakers began documenting his experience for the upcoming film, Ride with Larry. The documentary and accompanying awareness campaign seeks to enlighten audiences to the human cost of Parkinsons disease while providing insights into the tangible benefits of an active lifestyle, particularly through recumbent cycling, according to the films Facebook page.
More recently, Larry began to experiment with medical marijuana to treat his worsening symptoms. In a video uploaded to Ride with Larrys Facebook page last week, he arrives in San Diego, California, to obtain a license.
My symptoms are a great deal more obvious than ever before, and the pain is a little sharper, Larry says with some difficulty speaking.
Larrys at the point where hes having so much trouble walking, now he takes twenty pills a day, his wife Elizabeth explains, noting that increasing the dose could increase the side effects.
While in San Diego, Larry and his wife visit a medical marijuana doctor to obtain a prescription.
These are not the days of Reefer Madness, Larry observes in the video, referencing a 1936 propaganda film meant to demonize cannabis use. Yet I and millions of other people cant have it without facing serious jail time. Larry currently lives in South Dakota, which does not have a medical marijuana program.
In Part 2 of the series, Larry uses his prescription to purchase $40 worth of the plant at a dispensary in an attempt to ease his pain and rigid joints. Elizabeth tells the budtender at the dispensary that the side effects of Larrys pills have actually contributed to his dyskinesia. Further, she also discloses that every time she fills a prescription for him, it costs about $3,000, pointing out the stark difference in cost between pharmaceuticals and cannabis.
Though in Part 2, Larry buys actual buds, in Part 3 of 3, he meets with another man suffering from Parkinsons disease who gives him cannabis oil to place under his tongue. His relief is almost instantaneous. According to the videos description:
With a few drops of cannabis oil under his tongue, Larrys severe dyskinesia (uncontrolled movements), loss of voice, and tremors are calmed within in minutes! We didnt even edit the footage because the results were so startling.
Sure enough, the footage shows Larry placing the drops under his tongue before lying down. After just a few minutes, he sits up and it becomes apparent his uncontrolled movements have largely ceased.
His friend says, I think youve calmed down. Larry simply says, So quickly, as a smile comes over his face.
My voice is coming back, he also observes. In a voiceover, Elizabeth notes how his hands became rock steady after he tried the treatment.
It works most of the time, his friend observes after he sits up. Larry imitates the sound of a heavenly choir to demonstrate his immense relief.
Did you guys eat lunch? he asks the others in the room. You hungry now? his friend with Parkinsons inquires. Funny, I am, he replies.
As the video ends, Larry observes that A person like me could really use marijuana. And it makes me pretty angry that I cant get it in my home state.
At least one academic expert shares this frustration.
As Dr. Daniele Piomelli, a professor of Pharmacology at UC Irvines medical school, says in Part 3 of Larrys series:
The number one frustration that I have is knowing that there is this untapped potential that comes from what marijuana is teaching us to generate new medicines, and being stuck because of financial issues or political issues. That is extremely frustrating.
Dr. Piomelli, who runs a lab at the university, discussed recent research on cannabis effect on Parkinsons disease:
We know from animal experiments that the endogenous cannabinoid system is very important [in] regulating motor activity, the very type of activity that is impaired in Parkinsons disease. From animal experiments, we also know that boosting certain branches of the endocannabinoid system is helpful in relieving symptoms of Parkinsons. Finally, from anecdotal information, we know that certain patients who smoke marijuana experience relief [from] their symptoms.
Further, a 2014 study published in Clinical Neuropharmacology, researchers concluded there was significant improvement of sleep and pain scores for patients using cannabis to treat Parkinsons. They noted no significant adverse effects of the drug were observed but cautioned further research was necessary.
A 2014 study published in the Journal of Psychopharmacology explained that cannabidiol, or CBD, a non-psychoactive endocannabinoid, had the possible effect of improving quality of life measures in PD patients with no psychiatric comorbidities. They also advised more research was needed.
Even without the scientific research to back up the plants effectiveness, Larrys experience may provide hope to countless others suffering from debilitating ailments (Part 3 has been viewed over 20 million times as of this articles publication).
Though cannabis is becoming legal in a growing number of states, many people suffering from illnesses are unable to access the treatment. As Elizabeth said in Part 1:
I do not like the idea of breaking federal law. Even though the state law in California is very clear that its permissible, Im still uncomfortable. But, you know, if this is the only thing and as far as I know weve tried everything, and this is the only thing thats left we are going to give it a go and see how it goes.
And as she says in Part 3 after witnessing her husband finally experience relief:
We now know that medical marijuana controls dyskinesia, and yet its not available to us.
Still, as stories like Larrys continue to accumulate and the war on a plant continues to fail, the trend of legalization throughout the United States shows no signs of stopping.
First study: "There have also been some anecdotal reports suggesting that marijuana may be effective in alleviating certain ALS symptoms..."
Cherry picking, suppressing evidence, or the fallacy of incomplete evidence is the act of pointing to individual cases or data that seem to confirm a particular position, while ignoring a significant portion of related cases or data that may contradict that position.
It is a kind of fallacy of selective attention, the most common example of which is the confirmation bias.
Cherry picking may be committed intentionally or unintentionally.
Truth is treason in the empire of lies. - Ron Paul
"America is at that awkward stage. It's too late to work within the system, but too early to shoot the bastards."
It does not count when one doper says he has been peer reviewed by another doper when the test is rejected by official authorities. That counts for zero and any possession or use of marijauna remains a Federal crime.
marijuana has no currently accepted medical use because: As detailed in the HHS evaluation, the drugs chemistry is not known and reproducible; there are no adequate safety studies;
there are no adequate and well-controlled studies proving efficacy
81 Fed Reg No 156 (12 Aug 2016) 53767-53845, Proposed Rules Denial, Docket DEA-427
ClinicalTrials.gov is a database of publicly and privately supported clinical studies that is maintained by the NLM. Information about the clinical studies is provided by the Sponsor or Principal Investigator of the study. Information about the studies is submitted to the Web site (registered) when the studies begin, and is updated throughout the study. In some cases, results of the study or resulting publication citations are submitted to the Web site after the study ends
(https://clinicaltrials.gov/ct2/about-site/background). ClinicalTrials.gov was searched for all studies administering marijuana. The results of this search were used to confirm that no completed studies with published data were missed in the literature search. During the literature search, references found in relevant studies and systematic reviews were evaluated for additional relevant citations. All languages were included in the search. The PubMed search yielded a total of 566 abstracts. Of these abstracts, a full-text review was conducted with 85 papers to assess eligibility. From this evaluation, only eleven of 85 studies met the 6 CFR elements for inclusion as adequate and well-controlled studies.
None of the 11 adequate and well controlled studies proved efficacy. 74 studies failed to meet the standards of adequate and well-controlled studies.
marijuana has no currently accepted medical use because: As detailed in the HHS evaluation, the drugs chemistry is not known and reproducible; there are no adequate safety studies;
You obviously didn't even look at those two sources.
I don't have to look at your bullshit sources when the sole official source capable of approving the tests, or the drug, states that there has been no test whatsoever that has met the required standards and shown efficacy.
Typical doper whose brain is too fried to think. Argued to a court, this peer-reviewed bullshit gets destroyed like a doper's brain.
Americans for Safe Access v DEA (excerpt) peer review bs
DHHS makes the scientific and medical evaluations. If and when the effectiveness of kratom is established in well-controlled, well-designed, well-conducted, and well-documented scientific studies, including studies performed in a large number of patients, they may give your insatiable desires high consideration.
You are like a teen who does not take a road test but goes to the DMV for a drivers license and presents notes from various friends, neighbors, and mommy attesting to your being a safe driver. You do not get a license without a road test. DMV to Deckard: Because we say so.
Americans for Safe Access et al v. DEA, 11-1265 (D.C. Cir. 22 Jan 2013)
At 23:
In its scientific and medical evaluation, DHHS concluded that research on the medical use of marijuana ha[d] not progressed to the point that marijuana [could] be considered to have a currently accepted medical use or a currently accepted medical use with severe restrictions.Id. at 40,560. As noted above, DHHS recommendations are binding on the DEA insofar as they rest on scientific and medical determinations. 21 U.S.C. § 811(b). After an exhaustive examination of the issue, the DEA, adhering to DHHS recommendation, reached the following conclusion:
To establish accepted medical use, the effectiveness of a drug must be established in well-controlled, well-designed, well-conducted, and well-documented scientific studies, including studies performed in a large number of patients (57 FR 10499, 1992). To date, such studies have not been performed. The small clinical trial studies with limited patients and short duration are not sufficient to establish medical utility. Studies of longer duration are needed to fully characterize the drugs efficacy and safety profile. Scientific reliability must be established in multiple clinical studies. Furthermore, anecdotal reports and isolated case reports are not adequate evidence to support an accepted medical use of marijuana (57 FR 10499, 1992). The evidence from clinical research and reviews of earlier clinical research does not meet this standard.
At 26-28:
The DEA interprets adequate and well-controlled studies to mean studies similar to what the Food and Drug Administration (FDA) requires for a New Drug Application (NDA).See id. at 40,562. DHHS found that there have been no NDA-quality studies that have scientifically assessed the efficacy of marijuana for any medical condition. Id. It is well understood that, under FDA protocols, adequate and well-controlled investigations require clinical investigations, by experts qualified by scientific training and experience to evaluate the effectiveness of the drug involved, on the basis of which it could fairly and responsibly be concluded by such experts that the drug will have the effect it purports or is represented to have under the conditions of use prescribed, recommended, or suggested in the labeling or proposed labeling thereof. 21 U.S.C. § 355(d). This is a rigorous standard. See, e.g., Edison Pharm. Co. v. FDA, 600 F.2d 831, 843 (D.C. Cir. 1979) (holding that substantial evidence supported the FDAs conclusion that double-blind testing of a new drug was necessary before the drug could be administered to cardiac patients); Holland-Rantos Co. v. U.S. Dept of Health, Educ. and Welfare, 587 F.2d 1173, 1174 (D.C. Cir. 1978) (refusing to construe the requirement of a well-controlled investigation in a self-defeating fashion).
Contrary to what Petitioners suggest, something more than peer-reviewed studies is required to satisfy DEAs standard, and for good reason. [S]cientists understand that peer review per se provides only a minimal assurance of quality, and that the public conception of peer review as a stamp of authentication is far from the truth. Charles Jennings, Quality and Value: The True Purpose of Peer Review, NATURE.COM (2006), http://www.nature.com/nature/ peerreview/debate/nature05032.html; see also Lynn S. McCarty et al., Information Quality in Regulatory Decision Making: Peer Review versus Good Laboratory Practice, 120 ENVTL. HEALTH PERSP. 927, 930 (2012) (It is difficult to extract from the extensive body of work and commentary published over the last 25-30 years that scientific journal peer review is a coherent, consistent, reliable, evaluative procedure. . . . [T]he opposite conclusion may be more accurate.). Petitioners may have cited some peerreviewed articles in support of their position, but they have not pointed to adequate and well-controlled studies confirming the efficacy of marijuana for medicinal uses. If, as is the case here, there is substantial evidence to support the [agencys] finding that the[] studies [offered by petitioner] are not helpful, then petitioner must fail. Unimed, Inc. v. Richardson, 458 F.2d 787, 789 (D.C. Cir. 1972). In making this assessment, we must remind ourselves that our role in the Congressional scheme is not to give an independent judgment of our own, but rather to determine whether the expert agency entrusted with regulatory responsibility has taken an irrational or arbitrary view of the evidence assembled before it. Id.
The DEAs construction of its regulation is eminently reasonable. Therefore, we are obliged to defer to the agencys interpretation of adequate and well-controlled studies. See Thomas Jefferson Univ., 512 U.S. at 512 (deferring to an agencys interpretation of its own regulations). Judged against the DEAs standard, we find nothing in the record that could move us to conclude that the agency failed to prove by substantial evidence that such studies confirming marijuanas medical efficacy do not exist.
Finally, Petitioners suggested during oral argument that the Government had foreclosed the research that would be necessary to create sufficiently reliable clinical studies of marijuanas medical efficacy. Because Petitioners did not properly raise this issue with the DEA and there is nothing in the record to support it, we do not consider it here. We note, however, that DHHS recommendation explained that [t]he opportunity for scientists to conduct clinical research with marijuana exists under the [D]HHS policy supporting clinical research with botanical marijuana. Denial, 76 Fed. Reg. at 40,562. Thus, it appears that adequate and well-controlled studies are wanting not because they have been foreclosed but because they have not been completed.
When your bullshit goes to court, like a doper's brain, it gets destroyed.
Gonzales v. Raich 545 U.S. 1 (2005) at 14:
In enacting the CSA, Congress classified marijuana as a Schedule I drug. 21 U. S. C. § 812(c). This preliminary classification was based, in part, on the recommendation of the Assistant Secretary of HEW that marihuana be retained within schedule I at least until the completion of certain studies now underway. Schedule I drugs are categorized as such because of their high potential for abuse, lack of any accepted medical use, and absence of any accepted safety for use in medically supervised treatment. § 812(b)(1). These three factors, in varying gradations, are also used to categorize drugs in the other four schedules. For example, Schedule II substances also have a high potential for abuse which may lead to severe psychological or physical dependence, but unlike Schedule I drugs, they have a currently accepted medical use. § 812(b)(2). By classifying marijuana as a Schedule I drug, as opposed to listing it on a lesser schedule, the manufacture, distribution, or possession of marijuana became a criminal offense, with the sole exception being use of the drug as part of a Food and Drug Administration preapproved research study. §§823(f), 841(a)(1), 844(a); see also United States v. Oakland Cannabis Buyers Cooperative, 532 U. S. 483, 490 (2001).
At 27:
First, the fact that marijuana is used for personal medical purposes on the advice of a physician cannot itself serve as a distinguishing factor. Id., at 1229. The CSA designates marijuana as contraband for any purpose; in fact, by characterizing marijuana as a Schedule I drug, Congress expressly found that the drug has no acceptable medical uses.
CASES ADJUDGED
IN THE
SUPREME COURT OF THE UNITED STATES
AT
OCTOBER TERM, 2004
________________
GONZALES, ATTORNEY GENERAL, et al. v. RAICH et al.
CERTIORARI TO THE UNITED STATES COURT OF APPEALS FOR THE NINTH CIRCUIT
No. 03-1454. Argued November 29, 2004Decided June 6, 2005
Californias Compassionate Use Act authorizes limited marijuana use for medicinal purposes. Respondents Raich and Monson are California residents who both use doctor-recommended marijuana for serious medical conditions. After federal Drug Enforcement Administration agents seized and destroyed all six of Monsons cannabis plants, respondents brought this action seeking injunctive and declaratory relief prohibiting the enforcement of the federal Controlled Substances Act (CSA) to the extent it prevents them from possessing, obtaining, or manufacturing cannabis for their personal medical use. Respondents claim that enforcing the CSA against them would violate the Commerce Clause and other constitutional provisions. The District Court denied respondents motion for a preliminary injunction, but the Ninth Circuit reversed, finding that they had demonstrated a strong likelihood of success on the claim that the CSA is an unconstitutional exercise of Congress Commerce Clause authority as applied to the intrastate, noncommercial cultivation and possession of cannabis for personal medical purposes as recommended by a patients physician pursuant to valid California state law. The court relied heavily on United States v. Lopez, 514 U. S. 549, and United States v. Morrison, 529 U. S. 598, to hold that this separate class of purely local activities was beyond the reach of federal power.
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Syllabus
Held: Congress Commerce Clause authority includes the power to prohibit the local cultivation and use of marijuana in compliance with California law. Pp. 10-33.
(b) Congress power to regulate purely local activities that are part of an economic class of activities that have a substantial effect on interstate commerce is firmly established. See, e.g., Perez v. United States, 402 U. S. 146, 151. If Congress decides that the total incidence of a practice poses a threat to a national market, it may regulate the entire class. See, e.g., id., at 154-155. Of particular relevance here is Wickard v. Filburn, 317 U. S. 111, 127-128, where, in rejecting the appellee farmers contention that Congress admitted power to regulate the production of wheat for commerce did not authorize federal regulation of wheat production intended wholly for the appellees own consumption, the Court established that Congress can regulate purely intrastate activity that is not itself commercial, i.e., not produced for sale, if it concludes that failure to regulate that class of activity would undercut the regulation of the interstate market in that commodity. The similarities between this case and Wickard are striking. In both cases, the regulation is squarely within Congress commerce power because production of the commodity meant for home consumption, be it wheat or marijuana, has a substantial effect on supply and demand in the national market for that commodity. In assessing the scope of Congress Commerce Clause authority, the Court need not determine whether respondents activities, taken in the aggregate, substantially affect interstate commerce in fact, but only whether a rational basis exists for so concluding. E.g., Lopez, 514 U. S., at 557. Given the en-
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Syllabus
forcement difficulties that attend distinguishing between marijuana cultivated locally and marijuana grown elsewhere, 21 U. S. C. § 801(5), and concerns about diversion into illicit channels, the Court has no difficulty concluding that Congress had a rational basis for believing that failure to regulate the intrastate manufacture and possession of marijuana would leave a gaping hole in the CSA. Pp. 15-22.
(c) Respondents heavy reliance on Lopez and Morrison overlooks the larger context of modern-era Commerce Clause jurisprudence preserved by those cases, while also reading those cases far too broadly. The statutory challenges at issue there were markedly different from the challenge here. Respondents ask the Court to excise individual applications of a concededly valid comprehensive statutory scheme. In contrast, in both Lopez and Morrison, the parties asserted that a particular statute or provision fell outside Congress commerce power in its entirety. This distinction is pivotal for the Court has often reiterated that [w]here the class of activities is regulated and that class is within the reach of federal power, the courts have no power to excise, as trivial, individual instances of the class. Perez, 402 U. S., at 154. Moreover, the Court emphasized that the laws at issue in Lopez and Morrison had nothing to do with commerce or any sort of economic enterprise. See Lopez, 514 U. S., at 561; Morrison, 529 U. S., at 610. In contrast, the CSA regulates quintessentially economic activities: the production, distribution, and consumption of commodities for which there is an established, and lucrative, interstate market. Prohibiting the intrastate possession or manufacture of an article of commerce is a rational means of regulating commerce in that product. The Ninth Circuit cast doubt on the CSAs constitutionality by isolating a distinct class of activities that it held to be beyond the reach of federal power: the intrastate, noncommercial cultivation, possession, and use of marijuana for personal medical purposes on the advice of a physician and in accord-ance with state law. However, Congress clearly acted rationally in de-termining that this subdivided class of activities is an essential part of the larger regulatory scheme. The case comes down to the claim that a locally cultivated product that is used domestically rather than sold on the open market is not subject to federal regulation. Given the CSAs findings and the undisputed magnitude of the commercial market for marijuana, Wickard and its progeny foreclose that claim. Pp. 23-33.
352 F. 3d 1222, vacated and remanded.
STEVENS, J., delivered the opinion of the Court, in which KENNEDY, SOUTER, GINSBURG, and BREYER, JJ., joined. SCALIA, J., filed an opinion concurring in the judgment, post, p. 33. OCONNOR, J., filed a dissenting
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Syllabus
opinion, in which REHNQUIST, C. J., and THOMAS, J., joined as to all but Part III, post, p. 42. THOMAS, J., filed a dissenting opinion, post, p. 57.
Acting Solicitor General Clement argued the cause for petitioners. With him on the briefs were Assistant Attorney General Keisler, Deputy Solicitor General Kneedler, Lisa S. Blatt, Mark B. Stern, Alisa B. Klein, and Mark T. Quinlivan.
Randy E. Barnett argued the cause for respondents. With him on the brief were Robert A. Long, Jr., Heidi C. Doerhoff, Robert A. Raich, and David M. Michael.*
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*Briefs of amici curiae urging reversal were filed for the Community Rights Counsel by Timothy J. Dowling; for the Drug Free America Foundation, Inc., et al. by David G. Evans; for Robert L. DuPont, M. D., et al. by John R. Bartels, Jr.; and for U.S. Representative Mark E. Souder et al. by Nicholas P. Coleman.
Briefs of amici curiae urging affirmance were filed for the State of Alabama et al. by Troy King, Attorney General of Alabama, Kevin C. Newsom, Solicitor General, Charles C. Foti, Jr., Attorney General of Louisiana, and Jim Hood, Attorney General of Mississippi; for the State of California et al. by Bill Lockyer, Attorney General of California, Richard M. Frank, Chief Deputy Attorney General, Manuel M. Medeiros, State Solicitor, Taylor S. Carey, Special Assistant Attorney General, J. Joseph Curran, Jr., Attorney General of Maryland, and Christine O. Gregoire, Attorney General of Washington; for the California Nurses Association et al. by Julia M. Carpenter; for the Cato Institute by Douglas W. Kmiec, Timothy Lynch, and Robert A. Levy; for Constitutional Law Scholars by Ernest A. Young, Matthew D. Schnall, Charles Fried, and David L. Shapiro; for the Institute for Justice by William H. Mellor, Dana Berliner, and Richard A. Epstein; for the Leukemia & Lymphoma Society et al. by David T. Goldberg, Sean H. Donahue, and Daniel N. Abrahamson; for the Lymphoma Foundation of America et al. by Stephen C. Willey; for the Marijuana Policy Project et al. by Cheryl Flax-Davidson; and for the National Organization for the Reform of Marijuana Laws et al. by John Wesley Hall, Jr., Joshua L. Dratel, and Sheryl Gordon McCloud.
Briefs of amici curiae were filed for the Pacific Legal Foundation by M. Reed Hopper, Sharon L. Browne, and Deborah J. La Fetra; and for the Reason Foundation by Manuel S. Klausner.
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Opinion of the Court
JUSTICE STEVENS delivered the opinion of the Court.
California is one of at least nine States that authorize the use of marijuana for medicinal purposes.[1] The question presented in this case is whether the power vested in Congress by Article I, § 8, of the Constitution [t]o make all Laws which shall be necessary and proper for carrying into Execution its authority to regulate Commerce with foreign Nations, and among the several States includes the power to prohibit the local cultivation and use of marijuana in compliance with California law.
I
California has been a pioneer in the regulation of marijuana. In 1913, California was one of the first States to pro-hibit the sale and possession of marijuana,[2] and at the end of the century, California became the first State to authorize limited use of the drug for medicinal purposes. In 1996, California voters passed Proposition 215, now codified as the Compassionate Use Act of 1996.[3] The proposition was de-
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[1] See Alaska Stat. §§ 11.71.090, 17.37.01017.37.080 (Lexis 2004); Colo. Const., Art. XVIII, § 14, Colo. Rev. Stat. § 1818406.3 (Lexis 2004); Haw. Rev. Stat. §§ 329121 to 329128 (2004 Cum. Supp.); Me. Rev. Stat. Ann., Tit. 22, § 2383B(5) (West 2004); Nev. Const., Art. 4, § 38, Nev. Rev. Stat. §§453A.010453A.810 (2003); Ore. Rev. Stat. §§475.300475.346 (2003); Vt. Stat. Ann., Tit. 18, §§ 44724474d (Supp. 2004); Wash. Rev. Code §§ 69.51.01069.51.080 (2004); see also Ariz. Rev. Stat. Ann. § 133412.01 (West Supp. 2004) (voter initiative permitting physicians to prescribe Schedule I substances for medical purposes that was purportedly repealed in 1997, but the repeal was rejected by voters in 1998). In November 2004, Montana voters approved Initiative 148, adding to the number of States authorizing the use of marijuana for medical purposes.
[2] 1913 Cal. Stats. ch. 342, § 8a; see also Gieringer, The Origins of Cannabis Prohibition in California 2123 (rev. Mar. 2005), available at http:// www.canorml.org/background/caloriginsmjproh.pdf (all Internet materials as visited June 2, 2005, and available in Clerk of Courts case file).
[3] Cal. Health & Safety Code Ann. § 11362.5 (West Supp. 2005). The California Legislature recently enacted additional legislation supplementing the Compassionate Use Act. §§ 11362.711362.9.
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Opinion of the Court
signed to ensure that seriously ill residents of the State have access to marijuana for medical purposes, and to encourage Federal and State Governments to take steps to-ward ensuring the safe and affordable distribution of the drug to patients in need.[4] The Act creates an exemption from criminal prosecution for physicians,[5] as well as for pa-tients and primary caregivers who possess or cultivate mari-juana for medicinal purposes with the recommendation or approval of a physician.[6] A primary caregiver is a person who has consistently assumed responsibility for the housing, health, or safety of the patient.[7]
Respondents Angel Raich and Diane Monson are California residents who suffer from a variety of serious medical conditions and have sought to avail themselves of medical marijuana pursuant to the terms of the Compassionate Use
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[4] The people of the State of California hereby find and declare that the purposes of the Compassionate Use Act of 1996 are as follows:
(A) To ensure that seriously ill Californians have the right to obtain and use marijuana for medical purposes where that medical use is deemed appropriate and has been recommended by a physician who has determined that the persons health would benefit from the use of marijuana in the treatment of cancer, anorexia, AIDS, chronic pain, spasticity, glaucoma, arthritis, migraine, or any other illness for which marijuana provides relief.
(B) To ensure that patients and their primary caregivers who obtain and use marijuana for medical purposes upon the recommendation of a physician are not subject to criminal prosecution or sanction.
(C) To encourage the federal and state governments to implement a plan to provide for the safe and affordable distribution of marijuana to all patients in medical need of marijuana. § 11362.5(b)(1).
[5] Notwithstanding any other provision of law, no physician in this state shall be punished, or denied any right or privilege, for having recommended marijuana to a patient for medical purposes. § 11362.5(c).
[6] Section 11357, relating to the possession of marijuana, and Section 11358, relating to the cultivation of marijuana, shall not apply to a patient, or to a patients primary caregiver, who possesses or cultivates marijuana for the personal medical purposes of the patient upon the written or oral recommendation or approval of a physician. §11362.5(d).
[7] § 11362.5(e).
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Opinion of the Court
Act. They are being treated by licensed, board-certified family practitioners, who have concluded, after prescribing a host of conventional medicines to treat respondents conditions and to alleviate their associated symptoms, that marijuana is the only drug available that provides effective treatment. Both women have been using marijuana as a medication for several years pursuant to their doctors recommendation, and both rely heavily on cannabis to function on a daily basis. Indeed, Raichs physician believes that forgoing cannabis treatments would certainly cause Raich excruciating pain and could very well prove fatal.
Respondent Monson cultivates her own marijuana, and ingests the drug in a variety of ways including smoking and using a vaporizer. Respondent Raich, by contrast, is unable to cultivate her own, and thus relies on two caregivers, litigating as John Does, to provide her with locally grown marijuana at no charge. These caregivers also process the cannabis into hashish or keif, and Raich herself processes some of the marijuana into oils, balms, and foods for consumption. On August 15, 2002, county deputy sheriffs and agents from the federal Drug Enforcement Administration (DEA) came to Monsons home. After a thorough investigation, the county officials concluded that her use of marijuana was entirely lawful as a matter of California law. Nevertheless, after a 3-hour standoff, the federal agents seized and destroyed all six of her cannabis plants.
Respondents thereafter brought this action against the Attorney General of the United States and the head of the DEA seeking injunctive and declaratory relief prohibiting the enforcement of the federal Controlled Substances Act (CSA), 84 Stat. 1242, 21 U. S. C. § 801 et seq., to the extent it prevents them from possessing, obtaining, or manufacturing cannabis for their personal medical use. In their complaint and supporting afidavits, Raich and Monson described the severity of their afflictions, their repeatedly futile attempts
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Opinion of the Court
to obtain relief with conventional medications, and the opinions of their doctors concerning their need to use marijuana. Respondents claimed that enforcing the CSA against them would violate the Commerce Clause, the Due Process Clause of the Fifth Amendment, the Ninth and Tenth Amendments of the Constitution, and the doctrine of medical necessity.
The District Court denied respondents motion for a pre-liminary injunction. Raich v. Ashcroft, 248 F. Supp. 2d 918 (ND Cal. 2003). Although the court found that the federal enforcement interests wane[d] when compared to the harm that California residents would suffer if denied access to medically necessary marijuana, it concluded that respondents could not demonstrate a likelihood of success on the merits of their legal claims. Id., at 931.
A divided panel of the Court of Appeals for the Ninth Circuit reversed and ordered the District Court to enter a preliminary injunction.[8] Raich v. Ashcroft, 352 F. 3d 1222 (2003). The court found that respondents had demonstrated a strong likelihood of success on their claim that, as applied to them, the CSA is an unconstitutional exercise of Congress Commerce Clause authority. Id., at 1227. The Court of Appeals distinguished prior Circuit cases upholding the CSA in the face of Commerce Clause challenges by focusing on what it deemed to be the separate and distinct class of activities at issue in this case: the intrastate, noncommercial cultivation and possession of cannabis for personal medical purposes as recommended by a patients physician pursuant to valid California state law. Id., at 1228. The
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[8] On remand, the District Court entered a preliminary injunction enjoining petitioners from arresting or prosecuting Plaintiffs Angel McClary Raich and Diane Monson, seizing their medical cannabis, forfeiting their property, or seeking civil or administrative sanctions against them with respect to the intrastate, non-commercial cultivation, possession, use, and obtaining without charge of cannabis for personal medical purposes on the advice of a physician and in accordance with state law, and which is not used for distribution, sale, or exchange. Brief for Petitioners 9.
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Opinion of the Court
court found the latter class of activities different in kind from drug trafficking because interposing a physicians recommendation raises different health and safety concerns, and because this limited use is clearly distinct from the broader illicit drug marketas well as any broader commercial market for medicinal marijuanainsofar as the medicinal marijuana at issue in this case is not intended for, nor does it enter, the stream of commerce. Ibid.
The majority placed heavy reliance on our decisions in United States v. Lopez, 514 U. S. 549 (1995), and United States v. Morrison, 529 U. S. 598 (2000), as interpreted by recent Circuit precedent, to hold that this separate class of purely local activities was beyond the reach of federal power. In contrast, the dissenting judge concluded that the CSA, as applied to respondents, was clearly valid under Lopezand Morrison; moreover, he thought it simply impossible to distinguish the relevant conduct surrounding the cultivation and use of the marijuana crop at issue in this case from the cultivation and use of the wheat crop that affected interstate commerce in Wickard v. Filburn, 352 F. 3d, at 1235 (opinion of Beam, J.).
The obvious importance of the case prompted our grant of certiorari. 542 U.S. 936 (2004). The case is made difficult by respondents strong arguments that they will suffer irreparable harm because, despite a congressional finding to the contrary, marijuana does have valid therapeutic purposes. The question before us, however, is not whether it is wise to enforce the statute in these circumstances; rather, it is whether Congress power to regulate interstate markets for medicinal substances encompasses the portions of those markets that are supplied with drugs produced and consumed locally. Well-settled law controls our answer. The CSA is a valid exercise of federal power, even as applied to the troubling facts of this case. We accordingly vacate the judgment of the Court of Appeals.
Shortly after taking office in 1969, President Nixon declare a national war on drugs.[9] As the first campaign of that war, Congress set out to enact legislation that would consolidate various drug laws on the books into a comprehensive statute, provide meaningful regulation over legitimate sources of drugs to prevent diversion into illegal channels, and strengthen law enforcement tools against the traffic in illicit drugs.[10] That effort culminated in the passage of the Comprehensive Drug Abuse Prevention and Control Act of 1970, 84 Stat. 1236.
This was not, however, Congress first attempt to regulate the national market in drugs. Rather, as early as 1906 Congress enacted federal legislation imposing labeling regulations on medications and prohibiting the manufacture or shipment of any adulterated or misbranded drug traveling in interstate commerce.[11] Aside from these labeling restrictions, most domestic drug regulations prior to 1970 generally came in the guise of revenue laws, with the Department of the Treasury serving as the Federal Governments primary enforcer.[12] For example, the primary drug control law, before being repealed by the passage of the CSA, was the Harrison Narcotics Act of 1914, 38 Stat. 785 (repealed 1970).
The Harrison Act sought to exert control over the possession and sale of narcotics, specifically cocaine and opiates, by requiring producers, distributors, and purchasers to register with the Federal Government, by assessing taxes against
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[9] See D. Musto & P. Korsmeyer, The Quest for Drug Control 60 (2002) (hereinafter Musto & Korsmeyer).
[10] H. R. Rep. No. 911444, pt. 2, p. 22 (1970) (hereinafter H. R. Rep.); 26 Congressional Quarterly Almanac 531 (1970) (hereinafter Almanac); Musto & Korsmeyer 5657.
[11] Pure Food and Drugs Act of 1906, ch. 3915, 34 Stat. 768, repealed by Act of June 25, 1938, ch. 675, § 902(a), 52 Stat. 1059.
[12] See United States v. Doremus, 249 U. S. 86 (1919); Leary v. United States, 395 U. S. 6, 1416 (1969).
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parties so registered, and by regulating the issuance of prescriptions.[13]
Marijuana itself was not significantly regulated by the Federal Government until 1937 when accounts of marijuanas addictive qualities and physiological effects, paired with dissatisfaction with enforcement efforts at state and local levels, prompted Congress to pass the Marihuana Tax Act, 50 Stat. 551 (repealed 1970).[14] Like the Harrison Act, the Marihuana Tax Act did not outlaw the possession or sale of marijuana outright. Rather, it imposed registration and reporting requirements for all individuals importing, producing, selling, or dealing in marijuana, and required the payment of annual taxes in addition to transfer taxes whenever the drug changed hands.[15] Moreover, doctors wishing to prescribe marijuana for medical purposes were required to comply with rather burdensome administrative requirements.[16] Noncompliance exposed trafficker to severe federal penalties, whereas compliance would often subject them to prosecution under state law.[17] Thus, while the Marihuana Tax Act did not declare the drug illegal per se, the onerous administrative requirements, the prohibitively expensive taxes, and the risks attendant on compliance practically curtailed the marijuana trade.
Then in 1970, after declaration of the national war on drugs, federal drug policy underwent a significant transformation. A number of noteworthy events precipitated
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[13] See Doremus, 249 U. S., at 9093.
[14] R. Bonnie & C. Whitebread, The Marijuana Conviction 154174 (1999); L. Grinspoon & J. Bakalar, Marihuana, the Forbidden Medicine 78 (rev. ed. 1997) (hereinafter Grinspoon & Bakalar). Although this was the Federal Governments first attempt to regulate the marijuana trade, by this time all States had in place some form of legislation regulating the sale, use, or possession of marijuana. R. Isralowitz, Drug Use, Policy, and Management 134 (2d ed. 2002).
[15] Leary, 395 U. S., at 1416.
[16] Grinspoon & Bakalar 8.
[17] Leary, 395 U. S., at 1618.
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this policy shift. First, in Leary v. United States, 395 U. S. 6 (1969), this Court held certain provisions of the Marihuana Tax Act and other narcotics legislation unconstitutional. Second, at the end of his term, President Johnson fundamentally reorganized the federal drug control agencies. The Bureau of Narcotics, then housed in the Department of the Treasury, merged with the Bureau of Drug Abuse Control, then housed in the Department of Health, Education, and Welfare (HEW), to create the Bureau of Narcotics and Dangerous Drugs, currently housed in the Department of Justice.[18] Finally, prompted by a perceived need to consolidate the growing number of piecemeal drug laws and to enhance federal drug enforcement powers, Congress enacted the Comprehensive Drug Abuse Prevention and Control Act.[19]
Title II of that Act, the CSA, repealed most of the earlier antidrug laws in favor of a comprehensive regime to combat the international and interstate traffic in illicit drugs. The main objectives of the CSA were to conquer drug abuse and to control the legitimate and illegitimate traffic in controlled substances.[20] Congress was particularly concerned with the
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[18] Musto & Korsmeyer 3235; 26 Almanac 533. In 1973, the Bureau of Narcotics and Dangerous Drugs became the DEA. See Reorg. Plan No. 2 of 1973, § 1, 28 CFR § 0.100 (1973).
[19] The Comprehensive Drug Abuse Prevention and Control Act of 1970 consists of three titles. Title I relates to the prevention and treatment of narcotic addicts through HEW (now the Department of Health and Human Services). 84 Stat. 1238. Title II, as discussed in more detail above, addresses drug control and enforcement as administered by the Attorney General and the DEA. Id., at 1242. Title III concerns the import and export of controlled substances. Id., at 1285.
[20] In particular, Congress made the following findings:
(1) Many of the drugs included within this subchapter have a useful and legitimate medical purpose and are necessary to maintain the health and general welfare of the American people.
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need to prevent the diversion of drugs from legitimate to illicit channels.[21]
To effectuate these goals, Congress devised a closed regulatory system making it unlawful to manufacture, distribute, dispense, or possess any controlled substance except in a manner authorized by the CSA. 21 U.S.C. §§ 841(a)(1), 844(a). The CSA categorizes all controlled substances into five schedules. § 812. The drugs are grouped together based on their accepted medical uses, the potential for abuse, and their psychological and physical effects on the body.
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(2) The illegal importation, manufacture, distribution, and possession and improper use of controlled substances have a substantial and detrimental effect on the health and general welfare of the American people.
(3) A major portion of the traffic in controlled substances flows through interstate and foreign commerce. Incidents of the traffic which are not an integral part of the interstate or foreign flow, such as manufacture, local distribution, and possession, nonetheless have a substantial and direct effect upon interstate commerce because
(A) after manufacture, many controlled substances are transported in interstate commerce,
(B) controlled substances distributed locally usually have been transported in interstate commerce immediately before their distribution, and
(C) controlled substances possessed commonly flow through interstate commerce immediately prior to such possession.
(4) Local distribution and possession of controlled substances contribute to swelling the interstate traffic in such substances.
(5) Controlled substances manufactured and distributed intrastate cannot be differentiated from controlled substances manufactured and distributed interstate. Thus, it is not feasible to distinguish, in terms of controls, between controlled substances manufactured and distributed interstate and controlled substances manufactured and distributed intrastate.
(6) Federal control of the intrastate incidents of the traffic in controlled substances is essential to the effective control of the interstate incidents of such traffic. 21 U. S. C. §§ 801(1)(6).
[21] See United States v. Moore, 423 U. S. 122, 135 (1975); see also H. R. Rep., at 22.
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§§ 811, 812. Each schedule is associated with a distinct set of controls regarding the manufacture, distribution, and use of the substances listed therein. §§ 821-830. The CSA and its implementing regulations set forth strict requirements regarding registration, labeling and packaging, production quotas, drug security, and recordkeeping. Ibid.; 21 CFR § 1301 et seq. (2004).
In enacting the CSA, Congress classified marijuana as a Schedule I drug. 21 U. S. C. § 812(c). This preliminary classification was based, in part, on the recommendation of the Assistant Secretary of HEW that marihuana be retained within schedule I at least until the completion of certain studies now underway.[22] Schedule I drugs are categorized as such because of their high potential for abuse, lack of any accepted medical use, and absence of any accepted safety for use in medically supervised treatment. § 812(b)(1). These three factors, in varying gradations, are also used to categorize drugs in the other four schedules. For example, Schedule II substances also have a high potential for abuse which may lead to severe psychological or physical dependence, but unlike Schedule I drugs, they have a currently accepted medical use. § 812(b)(2). By classifying marijuana as a Schedule I drug, as opposed to listing it on a lesser schedule, the manufacture, distribution, or possession of marijuana became a criminal offense, with the sole exception being use of the drug as part of a Food and Drug Administration preapproved research study. §§ 823(f), 841(a)(1), 844(a); see also United States v. Oakland Cannabis Buyers Cooperative, 532 U. S. 483, 490 (2001).
The CSA provides for the periodic updating of schedules and delegates authority to the Attorney General, after consultation with the Secretary of Health and Human Services, to add, remove, or transfer substances to, from, or between
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[22] Id., at 61 (quoting letter from Roger O. Egeberg, M. D., to Hon. Harley O. Staggers (Aug. 14, 1970)).
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schedules. § 811. Despite considerable efforts to reschedule marijuana, it remains a Schedule I drug.[23]
III
Respondents in this case do not dispute that passage of the CSA, as part of the Comprehensive Drug Abuse Prevention and Control Act, was well within Congress commerce power. Brief for Respondents 22, 38. Nor do they contend that any provision or section of the CSA amounts to an unconstitutional exercise of congressional authority. Rather, respondents challenge is actually quite limited; they argue that the CSAs categorical prohibition of the manufacture and possession of marijuana as applied to the intrastate manufacture and possession of marijuana for medical purposes pursuant to California law exceeds Congress authority under the Commerce Clause. In assessing the validity of congressional regulation, none of our Commerce Clause cases can be viewed in isolation. As charted in considerable detail in United States v. Lopez, our understanding of the reach of the Commerce Clause, as well as Congress assertion of authority thereunder, has
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[23] Starting in 1972, the National Organization for the Reform of Marijuana Laws began its campaign to reclassify marijuana. Grinspoon & Bakalar 1317. After some fleeting success in 1988 when an Administrative Law Judge (ALJ) declared that the DEA would be acting in an unreasonable, arbitrary, and capricious manner if it continued to deny marijuana access to seriously ill patients, and concluded that it should be reclassified as a Schedule III substance, Grinspoon v. DEA, 828 F. 2d 881, 883884 (CA1 1987), the campaign has proved unsuccessful. The DEA Administrator did not endorse the ALJs findings, 54 Fed. Reg. 53767 (1989), and since that time has routinely denied petitions to reschedule the drug, most recently in 2001. 66 Fed. Reg. 20038 (2001). The Court of Appeals for the District of Columbia Circuit has reviewed the petition to reschedule marijuana on five separate occasions over the course of 30 years, ultimately upholding the Administrators final order. See Alliance for Cannabis Therapeutics v. DEA, 15 F. 3d 1131, 1133 (1994).
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evolved over time.[24] The Commerce Clause emerged as the Framers response to the central problem giving rise to the Constitution itself: the absence of any federal commerce power under the Articles of Confederation.[25] For the first century of our history, the primary use of the Clause was to preclude the kind of discriminatory state legislation that had once been permissible.[26] Then, in response to rapid industrial development and an increasingly interdependent national economy, Congress ushered in a new era of federal regulation under the commerce power, beginning with the enactment of the Interstate Commerce Act in 1887, 24 Stat. 379, and the Sherman Antitrust Act in 1890, 26 Stat. 209, as amended, 15 U. S. C. § 2 et seq.[27]
Cases decided during that new era, which now spans more than a century, have identified three general categories of regulation in which Congress is authorized to engage under its commerce power. First, Congress can regulate the channels of interstate commerce. Perez v. United States, 402 U. S. 146, 150 (1971). Second, Congress has authority to regulate and protect the instrumentalities of interstate commerce, and persons or things in interstate
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[24] United States v. Lopez, 514 U. S. 549, 552558 (1995); id., at 568574 (Kennedy, J., concurring); id., at 604607 (Souter, J., dissenting).
[25] See Gibbons v. Ogden, 9 Wheat. 1, 224 (1824) (opinion of Johnson, J.); Stern, That Commerce Which Concerns More States Than One, 47 Harv. L. Rev. 1335, 1337, 13401341 (1934); G. Gunther, Constitutional Law 127 (9th ed. 1975).
[26] See Lopez, 514 U. S., at 553554; id., at 568569 (Kennedy, J., concurring); see also Granholm v. Heald, 544 U. S. 460, 472473 (2005).
[27] Lopez, 514 U. S., at 554; see also Wickard v. Filburn, 317 U. S. 111, 121 (1942) (It was not until 1887, with the enactment of the Interstate Commerce Act, that the interstate commerce power began to exert positive influence in American law and life. This first important federal resort to the commerce power was followed in 1890 by the Sherman Anti-Trust Act and, thereafter, mainly after 1903, by many others. These statutes ushered in new phases of adjudication, which required the Court to approach the interpretation of the Commerce Clause in the light of an actual exercise by Congress of its power thereunder (footnotes omitted)).
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commerce. Ibid. Third, Congress has the power to regulate activities that substantially affect interstate commerce. Ibid.;NLRB v. Jones & Laughlin Steel Corp., 301 U. S. 1, 37 (1937). Only the third category is implicated in the case at hand.
Our case law firmly establishes Congress power to regulate purely local activities that are part of an economic class of activities that have a substantial effect on interstate commerce. See, e. g., Perez, 402 U. S., at 151; Wickard v. Filburn, 317 U. S. 111, 128-129 (1942). As we stated in Wickard, even if appellees activity be local and though it may not be regarded as commerce, it may still, whatever its nature, be reached by Congress if it exerts a substantial economic effect on interstate commerce. Id., at 125. We have never required Congress to legislate with scientific exactitude. When Congress decides that the total incidence of a practice poses a threat to a national market, it may regulate the entire class. See Perez, 402 U. S., at 154-155 ([W]hen it is necessary in order to prevent an evil to make the law embrace more than the precise thing to be prevented it may do so (quoting Westfall v. United States, 274 U. S. 256, 259 (1927))). In this vein, we have reiterated that when a general regulatory statute bears a substantial relation to commerce, the de minimis character of individual instances arising under that statute is of no consequence. E.g., Lopez, 514 U. S., at 558 (quoting Maryland v. Wirtz, 392 U. S. 183, 196, n. 27 (1968); emphasis deleted).
Our decision in Wickard, 317 U. S. 111, is of particular relevance. In Wickard, we upheld the application of regulations promulgated under the Agricultural Adjustment Act of 1938, 52 Stat. 31, which were designed to control the volume of wheat moving in interstate and foreign commerce in order to avoid surpluses and consequent abnormally low prices. The regulations established an allotment of 11.1 acres for Filburns 1941 wheat crop, but he sowed 23 acres, intending to use the excess by consuming it on his own farm. Filburn
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argued that even though we had sustained Congress power to regulate the production of goods for commerce, that power did not authorize federal regulation [of] production not intended in any part for commerce but wholly for consumption on the farm. Wickard, 317 U. S., at 118. Justice Jacksons opinion for a unanimous Court rejected this submission. He wrote:
The effect of the statute before us is to restrict the amount which may be produced for market and the extent as well to which one may forestall resort to the market by producing to meet his own needs. That appellees own contribution to the demand for wheat may be trivial by itself is not enough to remove him from the scope of federal regulation where, as here, his contribution, taken together with that of many others similarly situated, is far from trivial. Id., at 127-128.
Wickard thus establishes that Congress can regulate purely intrastate activity that is not itself commercial, in that it is not produced for sale, if it concludes that failure to regulate that class of activity would undercut the regulation of the interstate market in that commodity.
The similarities between this case and Wickard are striking. Like the farmer in Wickard, respondents are cultivating, for home consumption, a fungible commodity for which there is an established, albeit illegal, interstate market.[28] Just as the Agricultural Adjustment Act was designed to
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[28] Even respondents acknowledge the existence of an illicit market in marijuana; indeed, Raich has personally participated in that market, and Monson expresses a willingness to do so in the future. App. 59, 74, 87. See also Department of Revenue of Mont. v. Kurth Ranch, 511 U. S. 767, 770, 774, n. 12, and 780, n. 17 (1994) (discussing the market value of marijuana); id., at 790 (Rehnquist, C. J., dissenting); id., at 792 (OConnor, J., dissenting); Whalen v. Roe, 429 U. S. 589, 591 (1977) (addressing prescription drugs for which there is both a lawful and an unlawful market); Turner v. United States, 396 U. S. 398, 417, n. 33 (1970) (referring to the purchase of drugs on the retail market).
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control the volume [of wheat] moving in interstate and foreign commerce in order to avoid surpluses . . . and consequently control the market price, id., at 115, a primary purpose of the CSA is to control the supply and demand of controlled substances in both lawful and unlawful drug markets. See nn. 20-21, supra. In Wickard, we had no difficulty concluding that Congress had a rational basis for believing that, when viewed in the aggregate, leaving home-consumed wheat outside the regulatory scheme would have a substantial influence on price and market conditions. Here too, Congress had a rational basis for concluding that leaving home-consumed marijuana outside federal control would similarly affect price and market conditions.
More concretely, one concern prompting inclusion of wheat grown for home consumption in the 1938 Act was that rising market prices could draw such wheat into the interstate market, resulting in lower market prices. Wickard, 317 U. S., at 128. The parallel concern making it appropriate to include marijuana grown for home consumption in the CSA is the likelihood that the high demand in the interstate market will draw such marijuana into that market. While the diversion of homegrown wheat tended to frustrate the federal interest in stabilizing prices by regulating the volume of commercial transactions in the interstate market, the diversion of homegrown marijuana tends to frustrate the federal interest in eliminating commercial transactions in the interstate market in their entirety. In both cases, the regulation is squarely within Congress commerce power because production of the commodity meant for home consumption, be it wheat or marijuana, has a substantial effect on supply and demand in the national market for that commodity.[29]
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[29] To be sure, the wheat market is a lawful market that Congress sought to protect and stabilize, whereas the marijuana market is an unlawful market that Congress sought to eradicate. This difference, however, is of no constitutional import. It has long been settled that Congress power to regulate commerce includes the power to prohibit commerce in a particu-
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Nonetheless, respondents suggest that Wickard differs from this case in three respects: (1) the Agricultural Adjustment Act, unlike the CSA, exempted small farming operations; (2) Wickard involved a quintessential economic activitya commercial farmwhereas respondents do not sell marijuana; and (3) the Wickard record made it clear that the aggregate production of wheat for use on farms had a significant impact on market prices. Those differences, though factually accurate, do not diminish the precedential force of this Courts reasoning.
The fact that Filburns own impact on the market was trivial by itself was not a sufficient reason for removing him from the scope of federal regulation. 317 U. S., at 127. That the Secretary of Agriculture elected to exempt even smaller farms from regulation does not speak to his power to regulate all those whose aggregated production was significant, nor did that fact play any role in the Courts analysis. Moreover, even though Filburn was indeed a commercial farmer, the activity he was engaged inthe cultivation of wheat for home consumptionwas not treated by the Court as part of his commercial farming operation.[30] And while it is true that the record in the Wickard case itself established the causal connection between the production for local use and the national market, we have before us findings by Congress to the same effect.
Findings in the introductory sections of the CSA explain why Congress deemed it appropriate to encompass local activities within the scope of the CSA. See n. 20, supra. The
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lar commodity. Lopez, 514 U.S., at 571 (Kennedy, J., concurring) (In the Lottery Case, 188 U. S. 321 (1903), the Court rejected the argument that Congress lacked [the] power to prohibit the interstate movement of lottery tickets because it had power only to regulate, not to prohibit); see also Wickard, 317 U. S., at 128 (The stimulation of commerce is a use of the regulatory function quite as definitely as prohibitions or restrictions thereon).
30 See id., at 125 (recognizing that Filburns activity may not be regarded as commerce).
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submissions of the parties and the numerous amici all seem to agree that the national, and international, market for marijuana has dimensions that are fully comparable to those defining the class of activities regulated by the Secretary pursuant to the 1938 statute.[31] Respondents nonetheless insist that the CSA cannot be constitutionally applied to their activities because Congress did not make a specific finding that the intrastate cultivation and possession of marijuana for medical purposes based on the recommendation of a physician would substantially affect the larger interstate marijuana market. Be that as it may, we have never required Congress to make particularized findings in order to legislate, see Lopez, 514 U. S., at 562; Perez, 402 U. S., at 156, absent a special concern such as the protection of free speech, see, e.g., Turner Broadcasting System, Inc. v. FCC, 512 U. S. 622, 664-668 (1994) (plurality opinion). While congressional findings are certainly helpful in reviewing the substance of a congressional statutory scheme, particularly when the connection to commerce is not self-evident, and while we will consider congressional findings in our analysis when they are available, the absence of particularized findings does not call into question Congress authority to legislate.[32]
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[31] The Executive Office of the President has estimated that in 2000 American users spent $10.5 billion on the purchase of marijuana. Office of Nat. Drug Control Policy, Marijuana Fact Sheet 5 (Feb. 2004), http:// www.whitehousedrugpolicy.gov/publications/factsht/marijuana/index.html.
[32] Moreover, as discussed in more detail above, Congress did make findings regarding the effects of intrastate drug activity on interstate commerce. See n. 20, supra. Indeed, even the Court of Appeals found that those findings weigh[ed] in favor of upholding the constitutionality of the CSA. 352 F. 3d 1222, 1232 (CA9 2003) (case below). The dissenters, however, would impose a new and heightened burden on Congress (unless the litigants can garner evidence sufficient to cure Congress perceived inadequa[cies])that legislation must contain detailed findings proving that each activity regulated within a comprehensive statute is essential to the statutory scheme. Post, at 5355 (opinion of OConnor, J.); post, at 64 (opinion of Thomas, J.). Such an exacting requirement is not only un-
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In assessing the scope of Congress authority under the Commerce Clause, we stress that the task before us is a modest one. We need not determine whether respondents activities, taken in the aggregate, substantially affect interstate commerce in fact, but only whether a rational basis exists for so concluding. Lopez, 514 U. S., at 557; see also Hodel v. Virginia Surface Mining & Reclamation Assn., Inc., 452 U. S. 264, 276-280 (1981); Perez, 402 U. S., at 155-156; Katzenbach v. McClung, 379 U. S. 294, 299-301 (1964); Heart of Atlanta Motel, Inc. v. United States, 379 U. S. 241, 252-253 (1964). Given the enforcement difficulties that attend distinguishing between marijuana cultivated locally and marijuana grown elsewhere, 21 U. S. C. § 801(5), and concerns about diversion into illicit channels, we have no difficulty concluding that Congress had a rational basis for believing that failure to regulate the intrastate manufacture and possession of marijuana would leave a gaping hole in the CSA. Thus, as in Wickard, when it enacted comprehensive legislation to regulate the interstate market in a fungible commodity, Congress was acting well within its authority to make all Laws which shall be necessary and proper to regulate Commerce . . . among the several States. U. S. Const., Art. I, § 8. That the regulation ensnares some purely intra-state activity is of no moment. As we have done many times before, we refuse to excise individual components of that larger scheme.
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precedented, it is also impractical. Indeed, the principal dissents critique of Congress for not even including declarations specific to marijuana is particularly unpersuasive given that the CSA initially identified 80 other substances subject to regulation as Schedule I drugs, not to mention those categorized in Schedules IIV. Post, at 55 (opinion of OConnor, J.). Surely, Congress cannot be expected (and certainly should not be required) to include specific findings on each and every substance contained therein in order to satisfy the dissenters unfounded skepticism.
33 See n. 21, supra (citing sources that evince Congress particular concern with the diversion of drugs from legitimate to illicit channels).
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IV
To support their contrary submission, respondents rely heavily on two of our more recent Commerce Clause cases. In their myopic focus, they overlook the larger context of modern-era Commerce Clause jurisprudence preserved by those cases. Moreover, even in the narrow prism of respondents creation, they read those cases far too broadly.
Those two cases, of course, are Lopez, 514 U. S. 549, and Morrison, 529 U. S. 598. As an initial matter, the statutory challenges at issue in those cases were markedly different from the challenge respondents pursue in the case at hand. Here, respondents ask us to excise individual applications of a concededly valid statutory scheme. In contrast, in both Lopez and Morrison, the parties asserted that a particular statute or provision fell outside Congress commerce power in its entirety. This distinction is pivotal for we have often reiterated that [w]here the class of activities is regulated and that class is within the reach of federal power, the courts have no power to excise, as trivial, individual instances of the class. Perez, 402 U. S., at 154 (quoting Wirtz, 392 U. S., at 193 (emphasis deleted)); see also Hodel, 452 U. S., at 308.
At issue in Lopez, 514 U. S. 549, was the validity of the Gun-Free School Zones Act of 1990, which was a brief, single-subject statute making it a crime for an individual to possess a gun in a school zone. 104 Stat. 4844-4845, 18 U. S. C. § 922(q)(1)(A). The Act did not regulate any economic activity and did not contain any requirement that the possession of a gun have any connection to past interstate activity or a predictable impact on future commercial activity. Distinguishing our earlier cases holding that comprehensive regulatory statutes may be validly applied to local conduct that does not, when viewed in isolation, have a significant impact on interstate commerce, we held the statute invalid. We explained:
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Section 922(q) is a criminal statute that by its terms has nothing to do with commerce or any sort of economic enterprise, however broadly one might define those terms. Section 922(q) is not an essential part of a larger regulation of economic activity, in which the regulatory scheme could be undercut unless the intra-state activity were regulated. It cannot, therefore, be sustained under our cases upholding regulations of activities that arise out of or are connected with a commercial transaction, which viewed in the aggregate, substantially affects interstate commerce. 514 U.S., at 561.
The statutory scheme that the Government is defending in this litigation is at the opposite end of the regulatory spectrum. As explained above, the CSA, enacted in 1970 as part of the Comprehensive Drug Abuse Prevention and Control Act, 84 Stat. 1242-1284, was a lengthy and detailed statute creating a comprehensive framework for regulating the production, distribution, and possession of five classes of controlled substances. Most of those substancesthose listed in Schedules II through Vhave a useful and legitimate medical purpose and are necessary to maintain the health and general welfare of the American people. 21 U. S. C. § 801(1). The regulatory scheme is designed to foster the beneficial use of those medications, to prevent their misuse, and to prohibit entirely the possession or use of substances listed in Schedule I, except as a part of a strictly controlled research project.
While the statute provided for the periodic updating of the five schedules, Congress itself made the initial classifications. It identified 42 opiates, 22 opium derivatives, and 17 hallucinogenic substances as Schedule I drugs. 84 Stat. 1248. Marijuana was listed as the 10th item in the 3d subcategory. That classification, unlike the discrete prohibition established by the Gun-Free School Zones Act of 1990, was merely one of many essential part[s] of a larger regulation of economic activity, in which the regulatory scheme could be undercut
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unless the intrastate activity were regulated. Lopez, 514 U. S., at 561.[34] Our opinion in Lopez casts no doubt on the validity of such a program.
Nor does this Courts holding in Morrison, 529 U. S. 598. The Violence Against Women Act of 1994, 108 Stat. 1902, created a federal civil remedy for the victims of gender-motivated crimes of violence. 42 U. S. C. § 13981. The remedy was enforceable in both state and federal courts, and generally depended on proof of the violation of a state law. Despite congressional findings that such crimes had an adverse impact on interstate commerce, we held the statute unconstitutional because, like the statute in Lopez, it did not regulate economic activity. We concluded that the noneconomic, criminal nature of the conduct at issue was central to our decision in Lopez, and that our prior cases had identified a clear pattern of analysis: Where economic activity substantially affects interstate commerce, legislation regulating that activity will be sustained.[35] Morrison, 529 U. S., at 610.
Unlike those at issue in Lopez and Morrison, the activities regulated by the CSA are quintessentially economic. Economics refers to the production, distribution, and consumption of commodities. Websters Third New International
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[34] The principal dissent asserts that by [s]eizing upon our language in Lopez, post, at 46 (opinion of OConnor, J.), i. e., giving effect to our well-established case law, Congress will now have an incentive to legislate broadly. Even putting aside the political checks that would generally curb Congress power to enact a broad and comprehensive scheme for the purpose of targeting purely local activity, there is no suggestion that the CSA constitutes the type of evasive legislation the dissent fears, nor could such an argument plausibly be made. Post, at 47 (OConnor, J., dissenting).
[35] Lopez, 514 U. S., at 560; see also id., at 573574 (Kennedy, J., concurring) (stating that Lopez did not alter our practical conception of commercial regulation and that Congress may regulate in the commercial sphere on the assumption that we have a single market and a unified purpose to build a stable national economy).
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GONZALES v. RAICH
Opinion of the Court
Dictionary 720 (1966). The CSA is a statute that regulates the production, distribution, and consumption of commodities for which there is an established, and lucrative, interstate market. Prohibiting the intrastate possession or manufacture of an article of commerce is a rational (and commonly utilized) means of regulating commerce in that product.[36] Such prohibitions include specific decisions requiring that a drug be withdrawn from the market as a result of the failure to comply with regulatory requirements as well as decisions excluding Schedule I drugs entirely from the market. Because the CSA is a statute that directly regulates economic, commercial activity, our opinion in Morrison casts no doubt on its constitutionality.
The Court of Appeals was able to conclude otherwise only by isolating a separate and distinct class of activities that it held to be beyond the reach of federal power, defined as the intrastate, noncommercial cultivation, possession and use of marijuana for personal medical purposes on the advice of a physician and in accordance with state law. 352 F. 3d, at 1229. The court characterized this class as different in kind from drug trafficking. Id., at 1228. The differences between the members of a class so defined and the principal trafficker in Schedule I substances might be sufficient to justify a policy decision exempting the narrower class from the coverage of the CSA. The question, however, is whether Congress contrary policy judgment, i.e., its decision to include this narrower class of activities within the larger regulatory scheme, was constitutionally deficient. We have no difficulty concluding that Congress acted rationally in determining that none of the characteristics making up the purported class, whether viewed individually or in the aggregate, compelled an exemption from the CSA; rather, the subdivided class of activities defined by the Court
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[36] See 16 U. S. C. § 668(a) (bald and golden eagles); 18 U. S. C. § 175(a) (biological weapons); § 831(a) (nuclear material); § 842(n)(1) (certain plastic explosives); § 2342(a) (contraband cigarettes).
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Opinion of the Court
of Appeals was an essential part of the larger regulatory scheme.
First, the fact that marijuana is used for personal medical purposes on the advice of a physician cannot itself serve as a distinguishing factor. Id., at 1229. The CSA designates marijuana as contraband for any purpose; in fact, by characterizing marijuana as a Schedule I drug, Congress expressly found that the drug has no acceptable medical uses. Moreover, the CSA is a comprehensive regulatory regime specifically designed to regulate which controlled substances can be utilized for medicinal purposes, and in what manner. Indeed, most of the substances classified in the CSA have a useful and legitimate medical purpose. 21 U. S. C. § 801(1). Thus, even if respondents are correct that marijuana does have accepted medical uses and thus should be redesignated as a lesser schedule drug,[37] the CSA would still impose controls beyond what is required by California law. The CSA requires manufacturers, physicians, pharmacies, and other handlers of controlled substances to comply with statutory and regulatory provisions mandating registration with the DEA, compliance with specific production quotas, security controls to guard against diversion, recordkeeping and reporting obligations, and prescription requirements. See
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[37] We acknowledge that evidence proffered by respondents in this case regarding the effective medical uses for marijuana, if found credible after trial, would cast serious doubt on the accuracy of the findings that require marijuana to be listed in Schedule I. See, e. g., Institute of Medicine, Marijuana and Medicine: Assessing the Science Base 179 (J. Joy, S. Watson, & J. Benson eds. 1999) (recognizing that [s]cientific data indicate the potential therapeutic value of cannabinoid drugs, primarily THC [Tetrahydrocannabinol] for pain relief, control of nausea and vomiting, and appetite stimulation); see also Conant v. Walters, 309 F. 3d 629, 640643 (CA9 2002) (Kozinski, J., concurring) (chronicling medical studies recognizing valid medical uses for marijuana and its derivatives). But the possibility that the drug may be reclassified in the future has no relevance to the question whether Congress now has the power to regulate its production and distribution. Respondents submission, if accepted, would place all homegrown medical substances beyond the reach of Congress regulatory jurisdiction.
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GONZALES v. RAICH
Opinion of the Court
§§ 821-830; 21 CFR § 1301 et seq. (2004). Furthermore, the dispensing of new drugs, even when doctors approve their use, must await federal approval. United States v. Rutherford, 442 U. S. 544 (1979). Accordingly, the mere fact that marijuanalike virtually every other controlled substance regulated by the CSAis used for medicinal purposes cannot possibly serve to distinguish it from the core activities regulated by the CSA.
Nor can it serve as an objective marke[r] or objective facto[r] to arbitrarily narrow the relevant class as the dissenters suggest, post, at 47 (opinion of OConnor, J.); post, at 68 (opinion of Thomas, J.). More fundamentally, if, as the principal dissent contends, the personal cultivation, possession, and use of marijuana for medicinal purposes is beyond the outer limits of Congress Commerce Clause authority, post, at 42 (opinion of OConnor, J.), it must also be true that such personal use of marijuana (or any other homegrown drug) for recreational purposes is also beyond those outer limits, whether or not a State elects to authorize or even regulate such use. JUSTICE THOMAS separate dissent suffers from the same sweeping implications. That is, the dissenters rationale logically extends to place any federal regulation (including quality, prescription, or quantity controls) of any locally cultivated and possessed controlled substance for any purpose beyond the outer limits of Congress Commerce Clause authority. One need not have a degree in economics to understand why a nationwide exemption for the vast quantity of marijuana (or other drugs) locally cultivated for personal use (which presumably would include use by friends, neighbors, and family members) may have a substantial impact on the interstate market for this extraordinarily popular substance. The congressional judgment that an exemption for such a significant segment of the total market would undermine the orderly enforcement of the entire regulatory scheme is entitled to a strong presumption of validity. Indeed, that judgment is not only rational, but visible to the
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Opinion of the Court
naked eye, Lopez, 514 U. S., at 563, under any commonsense appraisal of the probable consequences of such an open-ended exemption.
Second, limiting the activity to marijuana possession and cultivation in accordance with state law cannot serve to place respondents activities beyond congressional reach. The Supremacy Clause unambiguously provides that if there is any conflict between federal and state law, federal law shall prevail. It is beyond peradventure that federal power over commerce is superior to that of the States to provide for the welfare or necessities of their inhabitants, however legitimate or dire those necessities may be. Wirtz, 392 U. S., at 196 (quoting Sanitary Dist. of Chicago v. United States, 266 U. S. 405, 426 (1925)). See also 392 U. S., at 195-196; Wickard, 317 U. S., at 124 ([N]o form of state activity can constitutionally thwart the regulatory power granted by the commerce clause to Congress). Just as state acquiescence to federal regulation cannot expand the bounds of the Commerce Clause, see, e.g.,Morrison, 529 U. S., at 661-662 (breyer, J., dissenting) (noting that 38 States requested federal intervention), so too state action cannot circumscribe Congress plenary commerce power. See United States v. Darby, 312 U. S. 100, 114 (1941) (That power can neither be enlarged nor diminished by the exercise or non-exercise of state power).[38]
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[38] That is so even if Californias current controls (enacted eight years after the Compassionate Use Act was passed) are effective, as the dissenters would have us blindly presume, post, at 5354 (opinion of OConnor, J.); post, at 63, 68 (opinion of Thomas, J.). Californias decision (made 34 years after the CSA was enacted) to impose stric[t] controls on the cultivation and possession of marijuana for medical purposes, post, at 62 (Thomas, J., dissenting), cannot retroactively divest Congress of its authority under the Commerce Clause. Indeed, Justice Thomas urgings to the contrary would turn the Supremacy Clause on its head, and would resurrect limits on congressional power that have long since been rejected. See post, at 41 (Scalia, J., concurring in judgment)(quoting McCulloch v. Maryland, 4 Wheat. 316, 424 (1819)) (To impose on [Congress]
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GONZALES v. RAICH
Opinion of the Court
Respondents acknowledge this proposition, but nonetheless contend that their activities were not an essential part of a larger regulatory scheme because they had been isolated by the State of California, and [are] policed by the State of California, and thus remain entirely separated from the market. Tr. of Oral Arg. 27. The dissenters fall prey to similar reasoning. See n. 38, supra, at 26 and this page. The notion that California law has surgically excised a discrete activity that is hermetically sealed off from the larger interstate marijuana market is a dubious proposition, and, more importantly, one that Congress could have rationally rejected.
Indeed, that the California exemptions will have a significant impact on both the supply and demand sides of the market for marijuana is not just plausible as the principal dissent concedes, post, at 56 (opinion of OCONNOR, J.), it is readily apparent. The exemption for physicians provides them with an economic incentive to grant their patients permission to use the drug. In contrast to most prescriptions for legal drugs, which limit the dosage and duration of the usage, under California law the doctors permission to
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the necessity of resorting to means which it cannot control, which another government may furnish or withhold, would render its course precarious, the result of its measures uncertain, and create a dependence on other governments, which might disappoint its most important designs, and is incompatible with the language of the constitution ).
Moreover, in addition to casting aside more than a century of this Courts Commerce Clause jurisprudence, it is noteworthy that Justice Thomas suggestion that States possess the power to dictate the extent of Congress commerce power would have far-reaching implications beyond the facts of this case. For example, under his reasoning, Congress would be equally powerless to regulate, let alone prohibit, the intrastate possession, cultivation, and use of marijuana for recreational purposes, an activity which all States strictly contro[l]. Indeed, his rationale seemingly would require Congress to cede its constitutional power to regulate commerce whenever a State opts to exercise its traditional police powers to define the criminal law and to protect the health, safety, and welfare of their citizens. Post, at 66 (dissenting opinion).
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Opinion of the Court
recommend marijuana use is open-ended. The authority to grant permission whenever the doctor determines that a patient is afflicted with any other illness for which marijuana provides relief, Cal. Health & Safety Code Ann. § 11362.5(b)(1)(A) (West Supp. 2005), is broad enough to allow even the most scrupulous doctor to conclude that some recreational uses would be therapeutic.[39] And our cases have taught us that there are some unscrupulous physicians who overprescribe when it is sufficiently profitable to do so.[40]
The exemption for cultivation by patients and caregivers can only increase the supply of marijuana in the California market.[41] The likelihood that all such production will
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[39] Californias Compassionate Use Act has since been amended, limiting the catchall category to [a]ny other chronic or persistent medical symptom that either: ...[s]ubstantially limits the ability of the person to conduct one or more major life activities as defined in the Americans with Disabilities Act of 1990, or [i]f not alleviated, may cause serious harm to the patients safety or physical or mental health. Cal. Health & Safety Code Ann. §§ 11362.7(h)(12)(A)(B) (West Supp. 2005).
[40] See, e. g., United States v. Moore, 423 U. S. 122 (1975); United States v. Doremus, 249 U. S. 86 (1919).
[41] The state policy allows patients to possess up to eight ounces of dried marijuana, and to cultivate up to 6 mature or 12 immature plants. Cal. Health & Safety Code Ann. § 11362.77(a) (West Supp. 2005). However, the quantity limitations serve only as a floor. Based on a doctors recommendation, a patient can possess whatever quantity is necessary to satisfy his medical needs, and cities and counties are given carte blanche to establish more generous limits. Indeed, several cities and counties have done just that. For example, patients residing in the cities of Oakland and Santa Cruz and in the counties of Sonoma and Tehama are permitted to possess up to 3 pounds of processed marijuana. Reply Brief for Petitioners 1819 (citing Proposition 215 Enforcement Guidelines). Putting that quantity in perspective, 3 pounds of marijuana yields roughly 3,000 joints or cigarettes. Executive Office of the President, Office of National Drug Control Policy, What Americas Users Spend on Illegal Drugs 24 (Dec. 2001), http://www.whitehousedrugpolicy.gov/publications/pdf/american_ users_spend_2002.pdf. And the street price for that amount can range anywhere from $900 to $24,000. DEA, Illegal Drug Price and Purity Report (Apr. 2003) (DEA02058).
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GONZALES v. RAICH
Opinion of the Court
promptly terminate when patients recover or will precisely match the patients medical needs during their convalescence seems remote; whereas the danger that excesses will satisfy some of the admittedly enormous demand for recreational use seems obvious.[42] Moreover, that the national and international narcotics trade has thrived in the face of vigorous criminal enforcement efforts suggests that no small number of unscrupulous people will make use of the California exemptions to serve their commercial ends whenever it is feasible to do so.[43] Taking into account the fact that California is only one of at least nine States to have authorized the medical use of marijuana, a fact Justice OCONNORs dissent conveniently disregards in arguing that the demonstrated effect on commerce while admittedly plausible is ultimately unsubstantiated, post, at 56, 55, Congress could have rationally concluded that the aggregate impact on the national market of all the transactions exempted from federal supervision is unquestionably substantial.
So, from the separate and distinct class of activities identified by the Court of Appeals (and adopted by the dissenters), we are left with the intrastate, noncommercial cultivation, possession and use of marijuana. 352 F. 3d, at 1229. Thus the case for the exemption comes down to the claim that a locally cultivated product that is used domestically
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[42] For example, respondent Raich attests that she uses 2.5 ounces of cannabis a week. App. 82. Yet as a resident of Oakland, she is entitled to possess up to 3 pounds of processed marijuana at any given time, nearly 20 times more than she uses on a weekly basis.
[43] See, e. g., People ex rel. Lungren v. Peron, 59 Cal. App. 4th 1383, 1386 1387, 70 Cal. Rptr. 2d 20, 23 (1997) (recounting how a Cannabis Buyers Club engaged in an indiscriminate and uncontrolled pattern of sale to thousands of persons among the general public, including persons who had not demonstrated any recommendation or approval of a physician and, in fact, some of whom were not under the care of a physician, such as undercover officers, and noting that some persons who had purchased marijuana on respondents premises were reselling it unlawfully on the street).
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SCALIA, J., concurring in judgment
rather than sold on the open market is not subject to federal regulation. Given the findings in the CSA and the undisputed magnitude of the commercial market for marijuana, our decisions in Wickard v. Filburn and the later cases endorsing its reasoning foreclose that claim.
V
Respondents also raise a substantive due process claim and seek to avail themselves of the medical necessity defense. These theories of relief were set forth in their complaint but were not reached by the Court of Appeals. We therefore do not address the question whether judicial relief is available to respondents on these alternative bases. We do note, however, the presence of another avenue of relief. As the Solicitor General confirmed during oral argument, the statute authorizes procedures for the reclassification of Schedule I drugs. But perhaps even more important than these legal avenues is the democratic process, in which the voices of voters allied with these respondents may one day be heard in the halls of Congress. Under the present state of the law, however, the judgment of the Court of Appeals must be vacated. The case is remanded for further proceedings consistent with this opinion.
It is so ordered.
[Page 33 continues with concurring opinion of Justice SCALIA.]
You obviously didn't even look at those two sources.
No need to read doper bullshit.
United States v. McIntosh, 15-10117 (9th Cir. 16 Aug 2016)
At 26:
Here, we must read § 542 with a view to its place in the overall statutory scheme for marijuana regulation, namely the CSA and the State Medical Marijuana Laws. The CSA prohibits the use, distribution, possession, or cultivation of any marijuana. See 21 U.S.C. §§ 841(a), 844(a).[4] The State Medical Marijuana Laws are those state laws that authorize the use, distribution, possession, or cultivation of medical marijuana. Thus, the CSA prohibits what the State Medical Marijuana Laws permit.
In light of the ordinary meaning of the terms of § 542 and the relationship between the relevant federal and state laws, we consider whether a superior authority, which prohibits certain conduct, can prevent a subordinate authority from implementing a rule that officially permits such conduct by punishing individuals who are engaged in the conduct officially permitted by the lower authority. We conclude that it can.
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[4] This requires a slight caveat. Under the CSA, the manufacture, distribution, or possession of marijuana [is] a criminal offense, with the sole exception being use of the drug as part of a Food and Drug Administration preapproved research study.Gonzales v. Raich, 545 U.S. 1, 14 (2005); see 21 U.S.C. §§ 812(c), 823(f), 841(a)(1), 844(a). Thus, except as part of a strictly controlled research project, federal law designates marijuana as contraband for any purpose.Raich, 545 U.S. at 24, 27.
Footnote 5 at 32-33:
[5] The prior observation should also serve as a warning. To be clear, § 542 does not provide immunity from prosecution for federal marijuana offenses. The CSA prohibits the manufacture, distribution, and possession of marijuana. Anyone in any state who possesses, distributes, or manufactures marijuana for medical or recreational purposes (or attempts or conspires to do so) is committing a federal crime. The federal government can prosecute such offenses for up to five years after they occur. See 18 U.S.C. § 3282. Congress currently restricts the government from spending certain funds to prosecute certain individuals. But Congress could restore funding tomorrow, a year from now, or four years from now, and the government could then prosecute individuals who committed offenses while the government lacked funding. Moreover, a new president will be elected soon, and a new administration could shift enforcement priorities to place greater emphasis on prosecuting marijuana offenses. Nor does any state law legalize possession, distribution, or manufacture of marijuana. Under the Supremacy Clause of the Constitution, state laws cannot permit what federal law prohibits. U.S. Const. art VI, cl. 2. Thus, while the CSA remains in effect, states cannot actually authorize the manufacture, distribution, or possession of marijuana. Such activity remains prohibited by federal law.
I don't have to look at your bullshit sources when the sole official source capable of approving the tests, or the drug, states that there has been no test whatsoever that has met the required standards and shown efficacy.
Well, you may choose to not look at Deckard's sources but I just so happened to stumble upon an article written by The Journal of American Medical Association that contradicts what DHHS has to say about cannabis. Had my mom been prescribing to cannabis rather than the continuous chemo treatments she was getting, she would be still be alive today. And what's worse is that at the same time she was getting those chemo treatments, those same doctors were administering flu shots on her which caused her to go code blue. So, I don't put too much faith on most doctors medicine these days.
Well, you may choose to not look at Deckard's sources but I just so happened to stumble upon an article written by The Journal of American Medical Association that contradicts what DHHS has to say about cannabis.
And remains unlawful with no accepted medical use. There is one regulating body and it is not JAMA or Dopers Are Us.
No amount of self-professed but unofficial claims of "peer reviewed" articles will satisfy the conditions placed upon every medical substance in the country. Some time back, laetrile, from peach pits, was the miracle cure.
Had my mom been prescribing to cannabis rather than the continuous chemo treatments she was getting, she would be still be alive today.
Sorry about your mom, but there is no way to know that marijuana would have worked where chemo failed.
So, I don't put too much faith on most doctors medicine these days.
If you choose, you are free to prefer witch doctors or dopers who profess that marijuana is the miracle cure for everything, or a Mexican clinic dispensing laetrile. If marijuana is the miracle cure, I should think the cancer rate in Columbia should be near zero.
Americans for Safe Access et al v. DEA, 11-1265 (D.C. Cir. 22 Jan 2013)
To establish accepted medical use, the effectiveness of a drug must be established in well-controlled, well-designed, well-conducted, and well-documented scientific studies, including studies performed in a large number of patients (57 FR 10499, 1992). To date, such studies have not been performed.
"On the merits, the question before the court is not whether marijuana could have some medical benefits. Rather, the limited question that we address is whether the DEAs decision declining to initiate proceedings to reschedule marijuana under the CSA was arbitrary and capricious. These questions are not coterminous. The scope of review under the arbitrary and capricious standard is narrow and a court is not to substitute its judgment for that of the agency. Motor Vehicle Mfrs. Assn of the U.S., Inc. v. State Farm Mut. Auto. Ins. Co., 463 U.S. 29, 43 (1983). On the record before us, we hold that the DEAs denial of the rescheduling petition survives review under the deferential arbitrary and capricious standard. The petition asks the DEA to reclassify marijuana as a Schedule III, IV, or V drug, which, under the terms of the CSA, requires a currently accepted medical use. The DEAs regulations, which we approved in Alliance for Cannabis Therapeutics v. DEA, 15 F.3d 1131 (D.C. Cir. 1994), define currently accepted medical use to require, inter alia, adequate and well-controlled studies proving efficacy. Id. at 1135. We defer to the agencys interpretation of these regulations and find that substantial evidence supports its determination that such studies do not exist."
Not only do those studies exist but I just cited those findings.
So, I don't put too much faith on most doctors medicine these days.
Please remember that medical doctors only have a license to "practice" medicine. If you ever notice, most deaths in America occur directly under a doctor's care, i.e, a hospital or medical clinic and so forth.
"On the merits, the question before the court is not whether marijuana could have some medical benefits. Rather, the limited question that we address is whether the DEAs decision declining to initiate proceedings to reschedule marijuana under the CSA was arbitrary and capricious. These questions are not coterminous. The scope of review under the arbitrary and capricious standard is narrow and a court is not to substitute its judgment for that of the agency. Motor Vehicle Mfrs. Assn of the U.S., Inc. v. State Farm Mut. Auto. Ins. Co., 463 U.S. 29, 43 (1983). On the record before us, we hold that the DEAs denial of the rescheduling petition survives review under the deferential arbitrary and capricious standard. The petition asks the DEA to reclassify marijuana as a Schedule III, IV, or V drug, which, under the terms of the CSA, requires a currently accepted medical use. The DEAs regulations, which we approved in Alliance for Cannabis Therapeutics v. DEA, 15 F.3d 1131 (D.C. Cir. 1994), define currently accepted medical use to require, inter alia, adequate and well-controlled studies proving efficacy. Id. at 1135. We defer to the agencys interpretation of these regulations and find that substantial evidence supports its determination that such studies do not exist."
Not only do those studies exist but I just cited those findings.
Are you a brain-damaged kangaroo?
Read the first sentence for context. You did not cite any adequate and well-controlled study proving efficacy.
The DEAs regulations, which we approved in Alliance for Cannabis Therapeutics v. DEA, 15 F.3d 1131 (D.C. Cir. 1994), define currently accepted medical use to require, inter alia, adequate and well-controlled studies proving efficacy. Id. at 1135.
There are no adequate and well-controlled studies proving efficacy.
There are NO SUCH studies. There is only (a) doper bullshit that does not qualify as adequate and well-controlled studies that have claimed to prove efficacy, and (b) adequate and well-controlled studies that do not prove efficacy.
A group of dopers on a mission, engaging in a self-congratulatory circle jerk, is a qualified peer-reviewed article in the same way that this site's dopers congratulating each other's profound discoveries is certification of scientific merit.
DEA: "proof of concept studies generally are not sufficient to prove efficacy of a drug because they provide only preliminary information about the effects of a drug."
DEA, 81 FR 53779-53781, August 12, 2016
Status of Research Into the Medical Uses for Marijuana
State-level public initiatives, including laws and referenda in support of the medical use of marijuana, have generated interest in the medical community and the need for high quality clinical investigation as well as comprehensive safety and effectiveness data. In order to address the need for high quality clinical investigations, the state of California established the Center for Medicinal Cannabis Research (CMCR, www.cmcr.ucsd.edu) in 2000 ''in response to scientific evidence for therapeutic possibilities of cannabis[9] and local legislative initiatives in favor of compassionate use'' (Grant, 2005). State legislation establishing the CMCR called for high quality medical research that would ''enhance understanding of the efficacy and adverse effects of marijuana as a pharmacological agent,'' but stressed the project ''should not be construed as encouraging or sanctioning the social or recreational use of marijuana.'' The CMCR funded many of the published studies on marijuana's potential use for treating multiple sclerosis, neuropathic pain, appetite suppression and cachexia. However, aside from the data produced by CMCR, no state-level medical marijuana laws have produced scientific data on marijuana's safety and effectiveness.
FDA approves medical use of a drug following a submission and review of an NDA or BLA. The FDA has not approved any drug product containing marijuana for marketing. Even so, results of small clinical exploratory studies have been published in the current medical literature. Many studies describe human research with marijuana in the United States under FDA-regulated IND applications.
However, FDA approval of an NDA is not the only means through which a drug can have a currently accepted medical use in treatment in the United States. In general, a drug may have a ''currently accepted medical use'' in treatment in the United States if the drug meets a five-part test. Established case law (Alliance for Cannabis Therapeutics v. DEA, 15 F.3d 1131, 1135 (D.C. Cir. 1994)) upheld the Administrator of DEA's application of the five-part test to determine whether a drug has a ''currently accepted medical use.'' The following describes the five elements that characterize ''currently accepted medical use'' for a drug[10]:
i. the drug's chemistry must be known and reproducible
''The substance's chemistry must be scientifically established to permit it to be reproduced into dosages which can be standardized. The listing of the substance in a current edition of one of the official compendia, as defined by section 201 G) of the Food, Drug and Cosmetic Act, 21 U.S.C. 321G), is sufficient to meet this requirement.''
ii. there must be adequate safety studies
''There must be adequate pharmacological and toxicological studies, done by all methods reasonably applicable, on the basis of which it could fairly and responsibly be concluded, by experts qualified by scientific training and experience to evaluate the safety and effectiveness of drugs, that the substance is safe for treating a specific, recognized disorder.''
iii. there must be adequate and well- controlled studies proving efficacy
''There must be adequate, well- controlled, well-designed, well-conducted, and well-documented studies, including clinical investigations, by experts qualified by scientific training and experience to evaluate the safety and effectiveness of drugs, on the basis of which it could be fairly and responsibly concluded by such experts that the substance will have the intended effect in treating a specific, recognized disorder.''
iv. the drug must be accepted by qualified experts
''The drug has a New Drug Application (NDA) approved by the Food and Drug Administration, pursuant to the Food, Drug and Cosmetic Act, 21 U.S.C. 355. Or, a consensus of the national community of experts, qualified by scientific training and experience to evaluate the safety and effectiveness of drugs, accepts the safety and effectiveness of the substance for use in treating a specific, recognized disorder. A material conflict of opinion among experts precludes a finding of consensus.'' and
v. the scientific evidence must be widely available
''In the absence of NDA approval, information concerning the chemistry, pharmacology, toxicology, and effectiveness of the substance must be reported, published, or otherwise widely available, in sufficient detail to permit experts, qualified by scientific training and experience to evaluate the safety and effectiveness of drugs, to fairly and responsibly conclude the substance is safe and effective for use in treating a specific, recognized disorder.''
Marijuana does not meet any of the five elements necessary for a drug to have a ''currently accepted medical use.''
Firstly, the chemistry of marijuana, as defined in the petition, is not reproducible in terms of creating a standardized dose. The petition defines marijuana as including all Cannabis cultivated strains. Different marijuana samples derived from various cultivated strains may have very different chemical constituents including delta9-THC and other cannabinoids (Appendino et al., 2011). As a consequence, marijuana products from different strains will have different safety, biological, pharmacological, and toxicological profiles. Thus, when considering all Cannabis strains together, because of the varying chemical constituents, reproducing consistent standardized doses is not possible. Additionally, smoking marijuana currently has not been shown to allow delivery of consistent and reproducible doses. However, if a specific Cannabis strain is grown and processed under strictly controlled conditions, the plant chemistry may be kept consistent enough to produce reproducible and standardized doses.
As to the second and third criteria; there are neither adequate safety studies nor adequate and well-controlled studies proving marijuana's efficacy. To support the petitioners' assertion that marijuana has accepted medical use, the petitioners cite the American Medical Association's (AMA) 2009 report entitled ''Use of Cannabis for Medicinal Purposes.'' The petitioners claim the AMA report is evidence the AMA accepts marijuana's safety and efficacy. However, the 2009 AMA report clarifies that the report ''should not be viewed as an endorsement of state-based medical cannabis programs, the legalization of marijuana, or that scientific evidence on the therapeutic use of cannabis meets the same and current standards for a prescription drug product.[11]''
Currently, no published studies conducted with marijuana meet the criteria of an adequate and well-controlled efficacy study. The criteria for an adequate and well-controlled study for purposes of determining the safety and efficacy of a human drug are defined under the Code of Federal Regulations (CFR) in 21 CFR 314.126. In order to assess this element, FDA conducted a review of clinical studies published and available in the public domain before February, 2013. Studies were identified through a search of PubMed[12] for articles published from inception to February 2013, for randomized controlled trials using marijuana to assess marijuana's efficacy in any therapeutic indication. Additionally, the review included studies identified through a search of bibliographic references in relevant systematic reviews and identified studies presenting original research in any language. Selected studies needed to be placebo-controlled and double-blinded. Additionally, studies needed to encompass administered marijuana plant material. There was no requirement for any specific route of administration, nor any age limits on study subjects. Studies were excluded that used placebo marijuana supplemented by the addition of specific amounts of THC or other cannabinoids. Additionally, studies administering marijuana plant extracts were excluded.
The PubMed search yielded a total of 566 abstracts of scientific articles. Of these abstracts, a full-text review was conducted with 85 papers to assess eligibility. Of the studies identified through the search of the references and the 566 abstracts from the PubMed search, only 11 studies met all the criteria for selection (Abrams et al., 2007; Corey-Bloom et al., 2012; Crawford and Merritt, 1979; Ellis et al., 2009; Haney et al., 2005; Haney et al., 2007; Merritt et al., 1980; Tashkin et al., 1974; Ware et al., 2010; Wilsey et al., 2008; Wilsey et al., 2013). These 11 studies were published between 1974 and 2013. Ten of these studies were conducted in the United States and one study was conducted in Canada. The identified studies examine the effects of smoked and vaporized marijuana for the indications of chronic neuropathic pain, spasticity related to Multiple Sclerosis (MS), appetite stimulation in human immunodeficiency virus (HIV) patients, glaucoma, and asthma. All studies used adult subjects.
The 11 identified studies were individually evaluated to determine if they successfully meet accepted scientific standards. Specifically, they were evaluated on study design including subject selection criteria, sample size, blinding techniques, dosing paradigms, outcome measures, and the statistical analysis of the results. The analysis relied on published studies, thus information available about protocols, procedures, and results were limited to documents published and widely available in the public domain. The review found that all 11 studies that examined effects of inhaled marijuana do not currently prove efficacy of marijuana in any therapeutic indication based on a number of limitations in their study design; however, they may be considered proof of concept studies. Proof of concept studies provide preliminary evidence on a proposed hypothesis involving a drug's effect. For drugs under development, the effect often relates to a short-term clinical outcome being investigated. Proof of concept studies often serve as the link between preclinical studies and dose ranging clinical studies. Thus, proof of concept studies generally are not sufficient to prove efficacy of a drug because they provide only preliminary information about the effects of a drug.
In addition to the lack of published adequate and well-controlled efficacy studies proving efficacy, the criteria for adequate safety studies has also not been met. Importantly, in its discussion of the five-part test used to determine whether a drug has a ''currently accepted medical use,'' DEA said, ''No drug can be considered safe in the abstract. Safety has meaning only when judged against the intended use of the drug, its known effectiveness, its known and potential risks, the severity of the illness to be treated, and the availability of alternative remedies'' (57 FR 10504). When determining whether a drug product is safe and effective for any indication, FDA performs an extensive risk-benefit analysis to determine whether the risks posed by the drug product's side effects are outweighed by the drug product's potential benefits for a particular indication. Thus, contrary to the petitioner's assertion that marijuana has accepted safety, in the absence of an accepted therapeutic indication which can be weighed against marijuana's risks, marijuana does not satisfy the element for having adequate safety studies such that experts may conclude that it is safe for treating a specific, recognized disorder.
The fourth of the five elements for determining ''currently accepted medical use'' requires that the national community of experts, qualified by scientific training and experience to evaluate the safety and effectiveness of drugs, accepts the safety and effectiveness of the substance for use in treating a specific, recognized disorder. A material conflict of opinion among experts precludes a finding of consensus. Medical practitioners who are not experts in evaluating drugs are not qualified to determine whether a drug is generally recognized as safe and effective or meets NDA requirements (57 FR 10499-10505).
There is no evidence that there is a consensus among qualified experts that marijuana is safe and effective for use in treating a specific, recognized disorder. As discussed above, there are not adequate scientific studies that show marijuana is safe and effective in treating a specific, recognized disorder. In addition, there is no evidence that a consensus of qualified experts have accepted the safety and effectiveness of marijuana for use in treating a specific, recognized disorder. Although medical practitioners are not qualified by scientific training and experience to evaluate the safety and effectiveness of drugs, we also note that the AMA's report, entitled ''Use of Cannabis for Medicinal Purposes,'' does not accept that marijuana currently has accepted medical use. Furthermore, based on the above definition of a ''qualified expert'', who is an individual qualified by scientific training and experience to evaluate the safety and effectiveness of a drug, state-level medical marijuana laws do not provide evidence of a consensus among qualified experts that marijuana is safe and effective for use in treating a specific, recognized disorder.
As to the fifth part of the test, which requires that information concerning the chemistry, pharmacology, toxicology, and effectiveness of marijuana to be reported in sufficient detail, the scientific evidence regarding all of these aspects is not available in sufficient detail to allow adequate scientific scrutiny. Specifically, the scientific evidence regarding marijuana's chemistry in terms of a specific Cannabis strain that could produce standardized and reproducible doses is not currently available.
Alternately, a drug can be considered to have a ''currently accepted medical use with severe restrictions'' (21 U.S.C. 812(b)(2)(B)), as allowed under the stipulations for a Schedule II drug. Yet, as stated above, currently marijuana does not have any accepted medical use, even under conditions where its use is severely restricted.
In conclusion, to date, research on marijuana's medical use has not progressed to the point where marijuana is considered to have a ''currently accepted medical use'' or a ''currently accepted medical use with severe restrictions.''
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[9] In this quotation the term cannabis is interchangeable with marijuana.
[10] 57 FR I 0499, 1050406 (March 26, 1992).
[11] In this quotation the term cannabis is used interchangeably for marijuana.
[12] The following search strategy was used, (cannabis OR marijuana) AND (therapeutic use OR therapy) AND (RCT OR randomized controlled trial OR systematic review OR clinical trial OR clinical trials) NOT (marijuana abuse[Mesh] OR addictive behavior OR substance related disorders).
The Journal of American Medical Association that contradicts what DHHS has to say about cannabis. Had my mom been prescribing to cannabis rather than the continuous chemo treatments she was getting, she would be still be alive today.
I'm sorry for your loss. Unfortunately some of the posters on this thread would much rather see someone suffer and die rather than to allow them access to cannabis.
I wonder how many would let their own children or parents suffer if cannabis was the only substance that could promise relief from pain or seizures?
Truth is treason in the empire of lies. - Ron Paul
"America is at that awkward stage. It's too late to work within the system, but too early to shoot the bastards."
Unfortunately some of the posters on this thread would much rather see someone suffer and die rather than to allow them access to cannabis.
That is an irresponsible vindictive claim where you show malicious ill will and a desire to hurt motivated entirely by spite and ignorance. You have no evidence to support your allegation, a allegation that is completely false in that there have been no events such as that you allege.
I wonder how many would let their own children or parents suffer if cannabis [were] the only substance that could promise relief from pain or seizures?
That is a rhetorical question asked solely to produce an effect or to make an assertion and not to elicit a reply .therefore it contribute nothing to whatever point you neglected to make.
The point I am making is that you and the others here who would deny cannabis to a sick child for relief from pain or seizures, or to help a veteran cope with PTSD, or to allow a chemo patient to keep down his food are sadistic ghouls, blinded by the propaganda fed to you by the government concerning the medicinal value of cannabis.
Truth is treason in the empire of lies. - Ron Paul
"America is at that awkward stage. It's too late to work within the system, but too early to shoot the bastards."
This article isn't about recreational marijuana you "Reefer Madness" freaks.
Yes it is. The intention is to come in the back door with an argument presenting an argument that marijuana is benign and "natural" then later expand the argument to say there there is no reason to object to its use as a recreational drug.
The best testimony in rebuttal is the debilitated condition of the people who use it and are obsessed with it.
That is an irresponsible vindictive claim where you show malicious ill will and a desire to hurt motivated entirely by spite and ignorance. You have no evidence to support your allegation, a allegation that is completely false in that there have been no events such as that you allege.
No that is not true. The DHHS is not in the business of practicing medicine and therefore they are not the experts in making such determinations about cannabis. Let the doctors in the research and development do their job.
There has been research done on the medicinal purposes of this herb. Furthermore, cannabis has already been included in many medicines doctors prescribe however it is not as effective because it has been mixed with other FDA medicines making it less effective. If the patients were administered just the raw dosage of cannabis, they would get results more promising than just a mixture compressed with other drug elements. The reason why cannabis has been mixed with other drug elements is so that the cannabis loses its true purpose of healing and this is good for the doctors and hospital administrations as they making a huge profit. Were cannabis to be administered in raw form and under close supervision, there would be positive results and it would put the hospitals out of business. Hospitals and doctors are not in the business of healing people. Your illness is their opportunity to staying in business. You are nothing to them but a walking paycheck everytime you need their services which is why the first thing they prey on is your health insurance policies because if you don't have enough to cover those outrageous hospital and medical expenses, they will take your home.
I'm sorry for your loss. Unfortunately some of the posters on this thread would much rather see someone suffer and die rather than to allow them access to cannabis.
Some assholes would tell the world that heroin should be legal. Then lots of kids would try it and fuck themselves for life.
You and your sicko ilk are ok with that. You don't know right from wrong.
Anyone can go buy some pot. Just ask Fred. He deals it for lunch money.