The Compassionate Care Act was signed into law in July of 2014, amidst a national political climate that seemed to indicate increasingly relaxed views towards both medical and recreational cannabis. A number of western states (Colorado, Oregon, and Washington), as well as the District of Columbia, had recently legalized recreational cannabis, and it seemed that New York might be poised to be one of the first eastern states to put these new national attitudes into law.
However, against the advice of doctors, the New York medical cannabis program is extremely restrictive. The new laws in New York specify that there can only be 20 dispensaries in the entire state of New York. This pans out to be one dispensary every 2,700 square miles. As of January 2016, there are only 71 medical marijuana patients in the entire state of New York. This has to do with tight restrictions on both who can be prescribed medical marijuana as well as who can do the prescribing. Doctors who wish to be legally allowed to prescribe medical marijuana must be an expert in the field of one of the handful of qualifying conditions, and must attend a class that can last up to four hours. Finding a doctor who is allowed to prescribe cannabis will be an obstacle for many patients in need. At the moment, New York makes medical marijuana available to patients who can prove that they are treating one of a handful of severe conditions. These currently include cancer, HIV/AIDS, ALS, MS, Parkinson’s, spasticity from spinal cord damage, epilepsy, irritable bowel syndrome, nerve damage and Huntington’s.
Despite some discussion of adding a few more severe conditions to this list, it would still only cover a fraction of the number of ailments which cannabis has proven to treat – not to mention its potential for use as a safer painkiller to replace or supplement more harmful opiate painkillers. During what has been called an opiate abuse epidemic, especially in the northeast, (including New York) this prospect should not be taken lightly by lawmakers. Like all laws, the New York medical cannabis laws send a message about the worldview of the lawmakers – and the message here, based on access allowed by law, is that they would rather have patients popping Oxycontin than using cannabis. This represents a total disconnect with what medical science has to say about the relative safety of cannabis versus opiates, and harkens back to a 1930s rash of false associations of cannabis with the racist perception of criminal culture of Mexican immigrants, as well as the racist view of black America and other minorities at the time. It would seem that these racist views persist to this day - since this rash of anti-cannabis hysteria during the great depression, there has been an increasingly common theme of studies finding cannabis to be safer than first thought during this hysteria. Even as early as 1944, the La Guardia report found marijuana use to be quite safe, finding through extensive research that it did not push users to criminal behavior, drive them insane, or lead to addiction and other drug use. But somehow, both cultural attitudes and drug laws have taken many decades to begin catching up to the rising tide of these studies – which today has become an overwhelming torrent.
Furthermore, in a move that seems to be motivated by nothing more than this outdated hysteria and irrational associations with the criminal world, the New York medical marijuana laws do not allow the smoking of cannabis flower. New York’s program is entirely based on the use of oils and extracts. For one thing, this policy is on its face, an arbitrary hassle – most of the studies proving the safety of cannabis use have been researching the use of smoked cannabis. Even just on this level, this policy creates unnecessary problems for patients – since cannabis extracts are much stronger and more expensive than most cannabis flower. Having this as the only option, even for new patients, does not make sense. But furthermore, a brief look into recent cannabis research reveals an even bigger problem with this “no smoking” policy. Besides the fact that there is little proof that smoking is more harmful than other methods, recent research has proven why it actually might be more effective than the use of extracts. Since the 90s, research has shed light on other cannabinoids such as CBD and CBN, which are not present in many THC extracts. Furthermore, a process dubbed the “entourage effect” has been observed. Compounds called terpenes (found at different levels in various cannabis flower) may act to alter and augment the effect of the THC, increasing its medical value for different purposes, depending on the levels of the various terpenes. These other cannabinoids as well as terpenes can be lost in the production of pure THC extract.
Western medical science typically isolates a chemical compound, and then uses that chemical specifically, in a concentrated way. It is difficult for a lawmaker, catering to sometimes conservative public opinion, to accept that in many forms of natural and plant medicine, the plant is best consumed in its full natural form. To some extent, this misunderstanding is just a cultural clash as cannabis medicine, and the naturopathic ideas that come with it its traditional use, find their way into modern western medicine. However, the use of unaltered ginger or valerian root has not met with such forceful political resistance – and this is due to myths that were spread in the racist hysteria of the 30s, and have yet to fade fully from the public consciousness. For many Americans, the use of cannabis is still heavily associated with criminal activity and harder drug use. Politicians and lawmakers placate their constituencies by writing such notions into laws like New York’s, even with the vast majority of the medical and scientific communities debunking these myths. These lawmakers should instead bring truth and science to the attention of voters, since their obligation to their constituencies does not just involve doing what voters think is best, but also writing legislation that factors in what science has to say about reality. For cannabis, this means acknowledging that research is just beginning to uncover the tip of the iceberg in terms of medical potential, that many old myths about danger and criminality have been gradually proven false, and that doctors and patients are the only ones who should be making decisions about if and how cannabis is used in medicine.