A little-known law may finally challenge the feds’ 30-year stall
in recognizing medical marijuana. But it also raises a big question:
Who decides what is medicine?
By now, America has heard a lot about Oakland, California medical
marijuana patient Angel McClary Raich. In arguments November 29
before the U.S. Supreme Court, Raich – possibly the most sympathetic
party to ever come before the High Court, a 38-year-old mother of
two with a list of ailments including an inoperable brain tumor,
wasting syndrome, uterine fibroid tumors, scoliosis, paralysis,
endometriosis, and more – got her chance to nail outgoing U.S.
Attorney General John Ashcroft et al. for trying to take away the
only medicine that has helped her. Her case has pitted California’s
Compassionate Use Act of 1996, which legalized limited medical use
of marijuana, against the federal Controlled Substances Act, under
which all marijuana is illegal. For Raich, cannabis is the only
treatment (out of 35 medicines tried) that has allowed her to keep
her weight up. Her doctor says losing it would be a death sentence.
The case is a mighty test of states’ rights, which this court has
previously favored. But the barrage of questions the justices fired
at Raich’s lawyer, Boston University professor Randy Barnett,
revealed more than the possible end of their so-called “federalist
revolution.” They revealed the interior machinations of a kind of
regulatory fever dream in which no government agency will confront
the increasingly embarrassing mass of scientific evidence in favor
of pot’s accepted use as medicine.
Justice Stephen Breyer highlighted the problem in his
questioning, suggesting this wasn’t a matter for the courts. If
Raich et al. were unhappy with the federal Drug Enforcement
Administration kicking down their doors and throwing them in jail,
possibly to die, he argued, why didn’t they go to the FDA “and take
marijuana off the list … that would be the obvious way to get what
they want.” In other words, it should be left to the regulatory
agencies. “Isn’t medicine by regulation better than medicine by
referendum?”
“They don’t let you answer any of the questions in any detail, so
I basically pointed him to our amicus brief, which chronicles the
obstructions that the government has put in the way of medical
cannabis research,” says Barnett. Holding up both this and a 1999
report by the Institute of Medicine, commissioned by drug czar John
Walters at the White House Office of National Drug Control Policy,
which goes into some detail about marijuana’s therapeutic effects
and the way research has been stymied for political reasons, Barnett
stood in the courtroom and stared at an impossible tautology: The
courts don’t want to rule on medical pot because it should be a
regulatory matter, and the regulatory agencies refuse to review it,
forcing it repeatedly into the courts. Meanwhile, the lives of
otherwise law-abiding citizens hang in the balance.
For over 30 years, activists and federal regulators have been
locked in a slow and outlandishly tortuous legal struggle over the
medical use of marijuana and who, if anyone, has the authority to
change marijuana’s status under the 1970 Controlled Substances Act
from a Schedule One narcotic, meaning it has “no accepted medical
use,” to one of four less-restrictive categories. Even though
comments like Breyer’s make it seem as though there is a clear
procedure for this, and a DEA judge even ruled in 1988 that it would
be illegal not to reschedule given the preponderance of evidence,
the DEA has dug in its heels and – defying logic, science, and,
apparently, the law – mutely refused to budge.
Two months ago, however, a new challenge to this chronic
obstruction was filed under a little-known 2002 law called the Data
Quality Act (DQA) that may turn out to be the pry bar that moves the
feds. The act is designed to force regulatory agencies to base
decisions on the best available science. Although it’s not part of
the Raich case and has received relatively little notice in
comparison, it may turn out be her salvation.
“I hope that what this does is wake the U.S. Deptartment of
Health and Human Services [HHS] up to doing a fair review of the
current [rescheduling petition],” says Hilary McQuie, campaign
director for Americans for Safe Access (ASA), who filed the Data
Quality Act petition. “Because I don’t feel like I should have to
take a regulatory agency to court. I feel like they should do a full
scientific review.
“When everyone’s saying the FDA should just do this, do they not
know that the DEA is in the way of the FDA doing this?” adds McQuie.
“It shouldn’t be this hard. It shouldn’t be law enforcement agencies
that make medical scientific decisions. But right now it is set up
that way.”
“Their gimmick is that they won’t let researchers have cannabis
for research,” says Barnett. Though the FDA’s recommendations
regarding drugs can allegedly force the DEA to at least consider
rescheduling, the two agencies work together to make that
impossible. Every potential avenue is only a loop. No legal pot, no
research; no research, no legal pot. “That’s the game that’s played:
If you object to the regulatory process, they say, ‘Yeah, but
there’s judicial review.’ If you get to judicial review, they say,
‘Oh, well, look back at the regulatory process; they’re the experts,
not us.’”
Signed by President Bill Clinton on his way out the door as part
of the Paperwork Reduction Act, the DQA was a corporate gimme that
was meant to help industries fight meddlesome regulations. Written
by former U.S. Office of Management and Budget head Jim Tozzi and
backed by a load of big tobacco money, it was meant to thwart or
delay decisions that cost industries money. Manufacturers, for
example, could use the DQA to delay environmental regulations that
were based on the Precautionary Principle, protecting people before
the scientific testing of toxins or whatnot were complete, which
could take years. The act was designed to sacrifice public health to
save industry a lot of hassle and money.
But the idea that regulatory agencies can only act on the best
science, which made many environmental and consumer groups nervous,
was also easily turned to activist purposes. In 2003, Americans for
Safe Access began studying the law for the potential to force the
U.S. Department of Health and Human Services – the FDA’s parent
agency – to change its statements about pot having no accepted
medical value. The group filed its petition with HHS on October 4
and, by way of a press conference, staged a civil disobedience at
the doors of the HHS building on October 5, where 14 patients and
advocates chanted “Schedule I to Schedule III, cannabis is helping
me,” and promptly got arrested.
“It certainly seems like a novel approach,” says Paul Armentano,
spokesperson for the National Organization for the Reform of
Marijuana Laws, or NORML. “In theory, it presses all the right
buttons. But when you’re talking about marijuana, there’s in theory
how these things should work and then there’s in practice how they
do work. But I believe it’s the first time that the DQA has been
used in such a manner.”
The Data Quality Act’s key provision, which makes it an
improvement on the Administrative Procedures Act that predated it,
is that the DQA is time-limited, so there’s less foot-dragging
allowed. The HHS has 60 days from the date of filing to give an
answer, or at least file for a limited extension to make a decision.
That date was last Monday, December 6. It also provides for judicial
review – yes, ’round and ’round and then back in the courts. But
this time, it’s back to the ASA’s home court, the 9th Circuit in
California, which is perceived as a friendly venue.
“If they don’t answer us on the 6th, that would almost be even
better,” says McQuie. “My understanding is that, if it reverts for
judicial review, it’s in the 9th Circuit, which would be favorable
for us.”
This is the court that ruled in favor of Angel Raich. And which
made medical marijuana legal (again) in California.
At least, that’s what they think will happen. No one’s really
totally sure. No Data Quality Act case has ever gotten that far.
A Legal Quagmire
Monday’s deadline came and, as expected, the HHS asked for a
60-day extension, which is evidently the most they can get before
the legal wrangling begins. Americans for Safe Access Executive
Director Steph Sherer met with representatives for HHS Secretary
Tommy Thompson, and was informed of the ´´ extension and that the
petition is under review by the FDA in consultation with National
Institute of Health’s National Institute on Drug Abuse, or NIDA.
Spokespersons for both the FDA and NIDA declined to comment,
saying they hadn’t been briefed on the petition. Activists say that
NIDA’s involvement is a bad sign, however, as the petition didn’t
ask for a refutation of pot’s potential for addiction (which is what
NIDA monitors) and NIDA has been one of the most active agencies
trying to keep pot on the list of most dangerous drugs.
It’s a stall, but under the DQA, the stall can only last so long.
Frustrating though it may be, this slog is infinitely speedier than
any of the attempts at rescheduling that have come before.
Consider the first petition, filed in 1972. Only two years after
marijuana was lumped with LSD, heroin, and mescaline in Schedule I,
NORML filed the first petition with the Bureau of Narcotics
Enforcement, the predecessor to the DEA, which stalled for three
years and then denied to hear the petition. A court forced them to
hear it, then the DEA (formed in 1973) killed it without any
hearings. A higher court of appeals again forced them to hear it,
but it was easily killed off once more. Finally, in 1986, after
another exhaustive, grinding court fight, the DEA caved in and
assigned the investigation to its own DEA Administrative Law Judge,
Francis L. Young.
Young spent two years hearing the testimony of scores of
scientists, doctors, medical marijuana patients, law enforcement
officers, agents, corrections officials and the like, and in 1988
came back with a stunning verdict. In one of the most celebrated
documents in the history of pot activism, Young issued a ruling of
over 100 pages, saying not only that the DEA must move pot to
Schedule II, to have controlled medical use like cocaine and opium,
but that “the evidence in this record clearly shows that marijuana
has been accepted as capable of relieving the distress of great
numbers of very ill people, and doing so with safety under medical
supervision. It would be unreasonable, arbitrary and capricious for
the DEA to continue to stand between those sufferers and the
benefits of this substance in light of the evidence of this record.”
“And he’s one of them!” cries Joe Elford, staff attorney for ASA,
and the chief author of the group’s DQA petition. “Anyone who does
administrative law generally thinks of it as a kangaroo court. It’s
one of their boys ruling on one of their issues, and you basically
expect to lose, and hopefully you might get some relief from a real
court down the line. But it was absolutely astounding that a DEA
administrative law judge would make such findings and certainly to
make ’em so forcefully.”
Of course, the DEA swept it all under the carpet. It decided that
Young had applied the wrong standard, that the testimony of doctors
and patients didn’t show “a currently accepted medical use.” The
record had to show controlled scientific testing – which neither the
FDA nor the DEA would allow by law.
That decision went through five appeals before it was finally
dead, in 1994, 22 years after the petition had been filed. But the
movement to reschedule saw cracks in the feds’ armor and picked up
steam. Dr. Jon Gettman, then the director of NORML, filed a new
rescheduling petition in 1995. This was finally denied in 2001 – it
only took seven years this time – but the reasons why it was denied
were more specific and easily attacked. The phrase “arbitrary and
capricious” began to resonate. It’s a magic one among lawyers,
especially those fighting regulatory agencies. The FDA, for
instance, has to set criteria to define “currently accepted medical
use,” and if it departs from them, it has abused its discretion,
which is against the law.
That’s where the DQA comes in. The new petition filed by
Americans for Safe Access invokes the DQA to charge that the FDA
abused its discretion on three of its five criteria in denying
Gettman’s 1995 rescheduling petition. Wherever the FDA deviates from
its own criteria, it seems they made an arbitrary and capricious
decision. That’s the legal basis for the case. Plus there’s more.
“That process requires by statute, a full and scientific medical
review,” says Gettman, who now has a new rescheduling petition
before the HHS as part of a coalition. “That review is supposed to
cover both the scientific evidence in the petition and everything
else that’s relevant. Now, what ASA is doing with the Data Quality
Act, as I understand it, is that they’re arguing that HHS’s review
of this 1995 petition of mine was inadequate and that it didn’t
cover all the available information.”
For instance, how could the FDA have reviewed the 1999 IOM study,
which found marijuana useful “for pain relief, control of nausea and
vomiting, and appetite stimulation,” and still denied accepted
medical use? It’s the White House’s own study. Not to mention the
massive – and growing – raft of other medical evidence available
before 2001, like the discovery of the receptor sites in the brain
that show exactly how tetrahydrocannabinoids work to relieve pain.
If the FDA is shown to have abused its discretion, this should
require the DEA to consider a new rescheduling procedure.
At least, in theory. “It gets complicated, and the trouble is
that the courts are still sorting it out,” says Elford. “The law’s
only a couple of years old. There have been, at this point, only a
handful of published decisions dealing with this case.”
Indeed, in a ruling that came down on December 3, a U.S. District
Court judge found that Data Quality Act challenges were not
judicially reviewable. Publishing on that ruling, Sean Moulton,
senior policy analyst at good government group OMB Watch, says,
“They’re [ASA] facing an uphill battle at this point. It’s not
outside the realm of possibility to get a precedent overturned,
depending on where they’re going to file. But I think that a lot of
the points that [this judge] made about standing would apply to many
other DQA cases that might get filed in court.”
Joe Elford knows he’s in for a long fight. He expects both the
HHS and the DEA to try every available dodge. It will take months.
There’s no set procedure for judicial review. But if it all goes
through, it could go to the 9th Circuit.
“We’re going to get a much better shake in the Northern district
of California,” he says a little dreamily. “And from there to the
9th Circuit Court of Appeals, and then … from there, possibly the
U.S. Supreme Court. But I’m certainly not holding my breath.”
Kafkaesque
So, what if pot is moved to Schedule II? It would still be
illegal in most circumstances, just like cocaine. But the hundreds
of patients who hold a doctor’s prescription would not risk having
the DEA kick down their doors at dawn. And Michael Teague, for one,
would not be in prison.
Like Angel Raich, Michael Teague is not the guy who comes to mind
when you imagine a dangerous drug user wanted by federal
authorities. On April 2, 2003, Orange County Sheriff’s deputies
searched his garage in Tustin and found 102 to 108 marijuana plants,
about half of them only one-inch high clones. Teague was then 33 and
the modestly successful owner of Aqua Chemical, a pool-cleaning
service, and the Sheriff’s Department treated this as a big score.
At least, until he pulled out his prescription for medical
marijuana. Teague had injured four vertebrae in his back while
wrestling in high school, and as he went through years of treatments
it was discovered that he was allergic to aspirin, ibuprofen, muscle
relaxers – in fact, most synthetic pain killers. His doctor then got
him on pot, and it worked.
“I never smoked until they told me I needed it,” says Teague,
speaking by phone from a halfway house in Garden Grove, where he is
finishing the last month of what has turned out to be an 18-month
sentence. “I didn’t get stoned every day. I don’t even drink
alcohol. I only smoked a few times a week at night so I could sleep
on the pain. I’ve never done anything wrong in my life.”
In fact, Michael Teague’s whole family is full up with cops. His
mother is retired from the police department, and his brother is a
deputy sheriff. They supported his idea to grow his own medicine
once a doctor said it was the way to go. His mother, who was
diagnosed with cancer, considered taking marijuana, too, until
Michael was arrested. “I understand why this medical marijuana needs
[federal approval],” she says. “I’m in chronic pain, and there’s
nothing they can give me.” They all believed they were obeying the
law to the letter.
State prosecutors agreed, finding Teague’s plants were under the
limit allowed by law and that he was abiding by Proposition 215,
refusing to charge him. Irritated, the Sheriff’s office and U.S.
Bureau of Alcohol, Tobacco and Firearms convinced the U.S.
Attorney’s office to pick it up as a federal case.
Then the weirdness began. Convinced he had a great case for
federal appeal, Teague chose a bench trial, freely admitting he had
grown the plants. The judge gave him assurances that this would
guarantee his rights to an appeal, and Teague expected to be out on
bail, since he was not a flight risk or a danger to the community.
Instead, the judge sentenced him to 18 months and remanded him to
federal prison that day. Seventeen months later, despite the efforts
of multiple lawyers, Michael Teague has never had a hearing
regarding his appeal, never got into a promised drug treatment
program (which would cut his time in half), never even received the
transcripts of his trial, which are guaranteed by law. On January 9,
2005, he will have served his full sentence in Terminal Island,
while other medical marijuana patients like Bryan Epis and Keith
Terry Alden were very quickly bailed out pending a decision on Raich
et al. v. Ashcroft et al., which will affect all of their appeals.
“Once you get into Bureau of Prisons custody, it pretty much
takes an act of God to get anything else done,” Teague says with a
sigh.
“I had to sell my house, I couldn’t afford it,” he adds. “I had
to sell my company because they locked me up so fast. I ran it for
12 years, started from scratch. I’ve owned three businesses, and
I’ve always been successful. I am a law-abiding citizen. I knew that
what I was doing was edgy – I’ll be honest – but I never knew that
they were going to take my company and my house and put me in
prison.”
Teague says now his fantasy is to leave the United States, since
it’s turned out that the legal system has failed him. Another
fantasy would be that pot gets rescheduled.
“The judge said it’s a Schedule One narcotic. I might as well
have had heroin, or crack; according to the federal government, it
doesn’t matter,” he says. “And it’s still Schedule One, that’s why I
can’t use it now. The judge just made it clear that this is an issue
that needs to be taken up by a higher court.”
Scheduling the Rescheduling
With another 60 days to stew while the FDA and NIDA look at their
petition, ASA’s Sherer says they’ll be turning up the heat, trying
to keep this moving, badgering members of Congress, running a
nationwide sign-on campaign to join the 7,000 doctors who’ve already
endorsed ASA’s effort. You might want to look at that number of
doctors again: 7,000. That’s a potential blizzard of prescriptions.
Sherer, who’s recently been working Capitol Hill relentlessly, can
feel the HHS beginning its long stall.
“My feeling is, this is information they’ve been looking at since
1972. They know we’re going to court if we’re denied, and they
definitely have a strategy of stalling it to keep us out of court,”
Sherer says.
“The bureaucrat’s favorite game is the stalling game. And we
don’t have time for that,” she adds. “We have patients who are
facing jail; we have patients who are living in fear of arrest. Our
objective is to get this taken care of as quickly as possible. If
they’re not going to accept the petition, they need to deny it
quickly so we can move on to the next step.”
“Just delaying it
doesn’t help anybody,” says the ASA’s McQuie. “It’s particularly
ironic after Justice Breyer’s comment that this should be in the
hands of regulators, and that Angel Raich should have just taken
this to the FDA and then challenged them in court if they denied it.
That’s exactly what we’re trying to do, but they just make it as
difficult as possible.”