The Opioid Crisis and Why Marijuana Should not be a Schedule I Drug
This article relates directly to the draft drug reform policy statement approved for study by the 2016 General Assembly. That statement and study are available online as Healing Before Punishment: Why the Presbyterian Church Seeks to End the War on Drugs.
Rich or poor; white, black, or brown; rural or urban—the opioid crisis plaguing our country afflicts us all.
Over 30,000 individuals died from a heroin overdose last year—1,300 in New York City alone. A presidential commission has just completed a massive study of the problem. And, recognizing the high stakes, police chiefs across the country are promising youth that if they turn in their drugs they will not arrest them, but instead help the youth find treatment. Naloxone, which can reverse many overdose effects, is now being increasingly carried by emergency services, police and even fire departments across the country. Doctors and insurance companies are re-evaluating the incentives that lead to over-prescribing opioids. State legislators are recognizing that massive cuts in national drug treatment and counseling programs are the wrong way to go.
Yet, one of the best ways to cut the opioid overdose rate is staring our culture right in the face.
Those paying close attention to the crisis may have noticed one of those remarkable ironies that sometimes emerge as national policy unfolds. In 1971, under the Controlled Substances Act, marijuana was categorized as a Schedule 1 drug. Along with heroin, it was deemed to have “no currently accepted medical use and a high potential for abuse.” But, mirabile dictu, as we now struggle with the opioid overdose deaths, evidence has emerged that this very same drug – marijuana – may in fact serve as an effective substitute for the often prescribed, far more clinically dangerous opioids.
One of the best ways to cut the opioid overdose rate is staring our culture right in the face.
A study published in the Journal for Alcohol and Drug Dependence recently found a 23% reduction in opioid hospitalizations after nine states passed legislation enabling the use of medical marijuana. A new study soon to be published in the Journal of American Medical Directors Association by University of New Mexico researchers has determined that medical marijuana patients significantly reduced their use of prescription drugs: over 70% of the medical marijuana users “either ceased or reduced their use of scheduled prescriptions within 6 months of enrolling.”
Marijuana as medicine will not, of course, solve the opioid crisis. But it can make a big difference. In relieving acute or chronic pain, it is far less expensive, does not bring the same debilitating side effects as the prescription drugs Vicodin and Oxycodone, is far less addictive; and, unlike opioids, does not kill through overdose. A small percentage of young people do use too much marijuana, hurting their studies, but even here the numbers and effects are much less than alcohol, which is much more addictive and linked to violence.
The simple explanation for marijuana’s status as a Schedule 1 drug is that President Richard Nixon, running for re-election, found it politically expedient to declare a War on Drugs in 1971.
How, then, did marijuana become a Schedule 1 drug, the most restrictive category on the federal drug registry, even as opioids are legal as prescription drugs? Perhaps the new findings about medical marijuana provides a teachable moment. It can prompt us to ask how such a misjudgment could have been made in the first place, and what have been its consequences.
The simple explanation for marijuana’s status as a Schedule 1 drug is that President Richard Nixon, running for re-election, found it politically expedient to declare a War on Drugs in 1971. Marijuana had temporarily been placed in this category while the prestigious Shafer Commission, which the President had appointed to advise him on marijuana policy, completed its work. The commission recommended that criminal penalties for marijuana use be reconsidered, and even hinted that it might be legalized.
President Nixon, however, ignored the commission for reasons his aide at the time, John Ehrlichman, later made abundantly clear when he said that,
“… by getting the public to associate the hippies with marijuana and blacks with heroin, and then criminalizing both heavily, we could disrupt those communities. We could arrest their leaders, raid their homes, break up their meetings, and vilify them night after night on the evening news. Did we know we were lying about the drugs? Of course we did.”
In devising this political calculus, Nixon and his staff were conforming to an ugly historical precedent. The origin of drug laws in the country is beyond the scope of this article, but it can be said succinctly that they were shaped in no small measure by a combination of press-driven hysteria and outright racism, first against cheap Chinese labor in the 1890’s and then against African Americans in the 1920’s and 1930’s.
The categorization of marijuana as a schedule I drug, then, is not a technical judgment about drug potency. It is a symptom, albeit an important one, of a national War on Drugs for the past forty-six years. This war has led to pernicious, even cruel laws, including harsh sentences for even low-level drug offenses; and collateral consequences such as loss of public assistance, access to housing, education, jobs, even the right to vote. Indeed, it has created a national posture about drugs and drug use. In the words of drug policy advocate Liz Evans, “[The] War on Drugs has not fixed addiction; it has fixed a mindset.”
Many, if not most, of the people we were trying to help shouldn’t have been in prison to begin with. They were drug war casualties.
Perhaps my experience in fighting for medical marijuana will demonstrate how deeply embedded this punitive ideology really is. In 2008, the Illinois organization I headed, Protestants for the Common Good, had entered the political arena on behalf of those getting out of prison who, then, as now, have no real second chance. “Paying your debt to society” is an American myth. As we worked for laws like expunging or sealing of records for low-level offenses, and lifting licensing barriers to employment for ex-offenders, it became obvious that many, if not most of the people we were trying to help shouldn’t have been in prison to begin with. They were drug war casualties.
But of course, within earshot of the Illinois General Assembly we couldn’t talk about changing drug policy. We could whisper the word “marijuana” – and only in the context of “medical marijuana.” For the next three years, we worked to gain legislative approval for medical marijuana. We fought nose-to-nose against law enforcement, physicians, educators and parents groups, and elected officials paralyzed by the thought that they might appear to be “soft on crime.”
In the end, we were successful. In August, 2013, Illinois Governor Pat Quinn signed into law the “Compassionate Use of Medical Cannabis Pilot Program Act.” Illinois became the 20th to approve medical marijuana. (The total is now 29, with over 50% of the U.S. population residing in such states.)
What were the specific arguments of law enforcement and others against the bill? Some were far-fetched: if medical marijuana were sitting in grandma’s medical cabinet, children would find and use it. (In fact, credible studies showed that in the 19 states that had legalized medical marijuana at that point, there had been no increase in youth use.)
Opponents envisioned workplaces with employers impaired due to marijuana (even though the bill specified that drug testing was permissible under the legislation). It was argued that DUIs due to marijuana would increase, even though field sobriety tests were and are available to police. Many argued that medical marijuana approval would implicitly sanction marijuana for recreational use.
Two arguments were blatantly hypocritical. Firstly, the most visible opponent of the bill was a former head of the Drug Enforcement Agency under President Reagan. “Medical marijuana has not been approved by the Food and Drug Administration,” he would intone. “We can’t use it as a drug. It’s not medicine.”
Academics have found it almost impossible to obtain marijuana for research […] Why? Because of the Schedule 1 designation. A perfect Catch-22.
He was right, of course, that the rigorous tests required by the FDA before a drug is approved for medical use have not been conducted for marijuana. I say “of course” because academics have found it almost impossible to obtain marijuana for research so that a product could be submitted to the FDA for approval. Why? Because of the Schedule 1 designation. A perfect Catch-22. Those who could change the schedule to enable marijuana research are the very ones who decry the lack of that research.
The second piece of rank hypocrisy was opponents’ unwillingness to recognize that marijuana, an illegal drug, is far safer than Vicodin and Oxycodone, readily available as prescription drugs. One of the leading advocates for medical marijuana suffered from degenerative spinal disease. He would hold up a huge glass jar of prescription drugs which he had tried at cost of over $50,000 per year. The side effects had nearly killed him. He would describe how, when he was near death, an Episcopal nun said to him, “I shouldn’t be telling you this, but if you continue to take these drugs, you will die. You should try marijuana.” He is now able to live a normal life.
There have been many comparable examples. Opponents have generally ignored them.
Nevertheless, cases of individual suffering are the overriding reason why medical marijuana passed in Illinois. During the final couple of years of the campaign, an increasingly large number of legislators came to realize that they knew friends, even relatives, for whom marijuana had been profoundly helpful in dire times – or might have been. In the final vote in the state senate, I remember my own senator, Kwame Raoul, standing up in the chamber and saying, his voice choking and eyes filled with tears, “The last days of my father’s life, when he was suffering terribly from cancer, would have been very different if medical marijuana had been available to him.”
Sessions clearly hasn’t been listening to the testimony of those whose lives were restored to wholeness.
For those who have worked hard for the approval of medical marijuana, the recent studies with evidence of marijuana as a substitute for prescription drugs might seem to be good news. But unfortunately, this will not happen if Attorney General Jeff Sessions has any say in the matter. Speaking before federal, state, and local law enforcement officials in March, he stated that he was “astonished to hear people suggest that we can solve our heroin crisis by legalizing marijuana – so people can trade one life-wrecking dependency for another that’s only slightly less awful. Our nation needs to say clearly once again that using drugs will destroy your life.”
Simply put, treating pain and disease with medication is not a sin.
Sessions clearly hasn’t been listening to the testimony of those whose lives were restored to wholeness. And he is not listening to the churches and medical personnel who know that healing must come before punishment if we actually want to reduce our rates of addiction. (See, for example, a drug reform proposal going before the Presbyterian Church’s 2018 General Assembly, based on a study approved in 2016).
Sessions seems intent taking us back to the 1980’s, when the War on Drugs was launched full bore and “Just Say No” was the answer. In fact, the attorney general has said that anyone who smokes marijuana is a bad person. He has stated his belief that all drug use is wrong, to the point where he equates drug use with violence, leaving no room for the treatment and harm reduction programs that are so critical in fighting the opioid overdose epidemic.
Simply put, treating pain and disease with medication is not a sin. But the categorizing of marijuana as a Schedule 1 drug does not seem likely to change under the current administration, even in the face of growing evidence that marijuana – the drug the federal drug registry tells us has no medical value – might help to relieve our national opioid overdose crisis. Why? Because a consideration of whether marijuana should be rescheduled will ultimately not be fought over the chemical properties of marijuana alone.
In the final analysis, the War on Drugs, within which the categorization of marijuana as a Schedule 1 drug is embedded, is about more than the labeling of particular substances. The routine strategies of the “War on Drugs” are devastating, and they play havoc with fundamental values of fairness and justice. The examples abound.
So, neither the reasons nor the effects of the War on Drugs are rational and just.
Excessive sentences for low-level, non-violent sentences, can and should be seen as cruel and unusual punishment. As often practiced, the doctrine of civil asset forfeiture violates the basic principle of innocent until proven guilty. When police to seize property suspected of being connected to a drug crime, owners must sue in order to prove their innocence and recover their properties. Consider the fact that our county jails are filled with those accused of minor drug offenses. Only those who can afford it are released while awaiting trial. The poor remain in jail, and are disproportionately African American and Hispanic. Cash bail sorts the rich from the poor and the white from the POC when determining punishment—before a conviction.
So, neither the reasons nor the effects of the War on Drugs are rational and just. It is clear that the one of the first decisions on which the War on Drugs was premised — the categorizing of marijuana as a Schedule 1 drug – is simply wrong. Far from being a drug of “no medical value,” marijuana can relieve pain in ways that are safer and more effective than drugs legally sold in pharmacies across the land. Meanwhile, the application of the law against users of marijuana has racial and class motivations wholly divorced from medical reality.
How much more evidence do we need for our political leaders to recognize that continuing to fight a punitive War on Drugs not only defies common sense about how drugs should be scheduled, but does so does in a discriminatory way, violating our most cherished national values?
AUTHOR BIO: The Rev. Alexander E. Sharp, a minister in the United Church of Christ, served in various capacities at the University of Chicago Divinity School prior to becoming Director of Protestants for The Common Good. Rev. Sharp is now devoting full time to Clergy for a New Drug Policy. He and his wife Margaret O’Dell live in Chicago and are members of Hyde Park Union Church.
A more complete bio may be found on the Clergy for a New Drug Policy site.