Medical cannabis in the United States

[10][11] By the end of the 19th century, the use of cannabis in medicine had declined due to a number of factors, including difficulty in controlling dosages and the rise in popularity of synthetic and opium-derived drugs.

Despite the strict federal prohibition in place, cannabis continued to gain renewed interest as medicine in the 1970s and 1980s, in particular due to the testimonials of cancer and AIDS patients who reported significant relief from the effects of chemotherapy and wasting syndrome.

Although the report did not address the subject of scheduling,[17] it found that the harms caused by cannabis were overstated, and recommended removal of criminal penalties for possession and distribution of small amounts of the drug.

[22] A 2016 FDA review concluded that cannabis has "no currently accepted medical use in treatment in the United States", in response to a petition filed with the DEA in 2011 by the governors of Washington and Rhode Island.

[24][25] Congressional attempts to reschedule have failed as well, including a 1981 bill introduced by Representatives Stewart McKinney and Newt Gingrich that grew to 84 cosponsors but never received a floor vote.

[9] In September 1988, after two years of extensive public hearings, DEA Chief Administrative Law Judge Francis L. Young ruled in favor of moving cannabis to a Schedule II classification, finding that "Marijuana, in its natural form, is one of the safest therapeutically active substances known to man.

"[33][34] Young concluded: "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.

[38] The program allowed patients with serious medical conditions to receive a regular supply of cannabis from the federal government; however, only 13 ended up participating due to the complicated and drawn-out application process involved.

[39] James O. Mason, the head of U.S. Public Health Service, explained that keeping the program in place created the perception that "this stuff can't be so bad", and noted that AIDS patients provided with cannabis would be more likely to engage in unsafe sex.

[41] Concurrent with the re-election of President Bill Clinton in 1996, California voters approved Proposition 215 to legalize the medical use of cannabis, and a similar (but ultimately ineffective) measure was passed in Arizona.

[4] Drug czar Barry McCaffrey also railed strongly against the medical use of cannabis – deriding it as "Cheech & Chong medicine" – and worked behind closed doors to coordinate a media campaign to sway public opinion against approving further initiatives.

[45] Despite previously speaking in support of states' rights on the issue of medical cannabis,[46] President George W. Bush escalated efforts to enforce federal law during his 8 years in office, with more than 260 raids conducted and 84 individuals prosecuted by his administration.

[4] Heavy use of paramilitary tactics and gear was common in execution of the raids, along with the frequent use of civil forfeiture, allowing cash and property to be seized without need for criminal conviction.

[2] The presidency of Barack Obama was noted for a strong federal crackdown on medical cannabis during his first term in office, despite early indications that his administration would take a more hands-off approach.

[59] U.S. District Judge Charles Breyer ruled against the Justice Department in October 2015, however, stating that the DOJ interpretation "defies language and logic" and "tortures the plain meaning of the statute", and was "counterintuitive and opportunistic".

[12] Additionally, the city board of supervisors passed a resolution in August 1992 urging the police commission and district attorney to "make lowest priority the arrest or prosecution of those involved in the possession or cultivation of [cannabis] for medicinal purposes" and to "allow a letter from a treating physician to be used as prima facia evidence that marijuana can alleviate the pain and suffering of that patient's medical condition".

[65] Following the lead of San Francisco and other cities in California, state lawmakers passed Senate Joint Resolution 8 in 1993, a non-binding measure calling on the federal government to enact legislation allowing physicians to prescribe cannabis.

[66] And Assembly Bill 1529 was approved in 1995, to create a medical necessity defense for patients using cannabis with a physician's recommendation, for treatment of AIDS, cancer, glaucoma, and multiple sclerosis.

[67] Proposition 215 – the Compassionate Use Act of 1996 – was subsequently approved with 56% of the vote, legalizing the use, possession, and cultivation of cannabis by patients with a physician's recommendation, for treatment of cancer, anorexia, AIDS, chronic pain, spasticity, glaucoma, arthritis, migraine, or "any other illness for which marijuana provides relief".

[16] Also, in Washington, D.C., Initiative 59 to legalize the medical use of cannabis passed with 69% of the vote,[72] but a series of amendments introduced by Rep. Bob Barr and approved by Congress prevented its implementation for over a decade.

[16] In the following years, medical cannabis was legalized by ballot measure in Montana (2004), Michigan (2008), Arizona (2010), Massachusetts (2012), Arkansas (2016), Florida (2016), North Dakota (2016), Oklahoma (2018), Missouri (2018), Utah (2018), and South Dakota (2020),[a] and by an act of state legislature in Vermont (2004), Rhode Island (2006), New Mexico (2007), New Jersey (2010), Delaware (2011), Connecticut (2012), New Hampshire (2013), Illinois (2013), Maryland (2014), Minnesota (2014), New York (2014), Pennsylvania (2016), Louisiana (2016), Ohio (2016), West Virginia (2017), Virginia (2020), Alabama (2021), Mississippi (2022), and Kentucky (2023).

[85] The use of CBD to treat seizure disorders gained increased attention with a number of media reports in 2012 and 2013, and by the end of 2015 sixteen states had "low-THC, high-CBD" laws in effect.

[86] Critics of the former NIDA monopoly have pointed to the case of University of Massachusetts Amherst professor Lyle Craker as an example of the DEA's undue resistance to granting additional cultivation licenses.

Senators John Kerry and Ted Kennedy wrote a letter to DEA Administrator Karen Tandy expressing support for granting Professor Craker a license.

[24] On February 12, 2007, after almost two years of extensive public testimony and evidence gathering, DEA Administrative Law Judge Ellen Bittner issued an 87-page opinion in favor of granting Professor Craker a license.

[24] On August 11, 2016, the DEA announced intention to issue additional licenses for the cultivation of research-grade cannabis, in order to end the decades-long monopoly held by NIDA and the University of Mississippi.

[133] American Legion, the nation's largest military veterans organization, passed a resolution at their September 2016 annual convention calling on Congress to remove cannabis from the list of Schedule I drugs.

[155] Eugene Monroe, Derrick Morgan, Kyle Turley, and Jim McMahon are among a group of NFL players that have advocated for allowing the use of cannabis in the league, as a treatment option for concussions and a pain reliever that can reduce reliance on addictive opioid drugs.

[163] Individuals who have been particularly active in opposing the medical use of cannabis include Barry McCaffrey,[45] John Walters,[165] Andrea Barthwell,[166] Bill Montgomery,[167][168] Mark Souder,[169] Sheldon Adelson,[170] Mel Sembler,[171] and Kevin Sabet.

[185] Syndros is manufactured by Insys Therapeutics, which received attention in 2016 for contributing heavily to the defeat of a cannabis legalization measure in Arizona, in an apparent attempt to protect market share for the newly developed drug.