Lurie Daniel Favors Show

Cannabis Prohibition & Health Outcomes

Was Marijuana always illegal? How did this start?

Prior to prohibition, cannabis was mostly used as medicine, industrial hemp, and recreation among a small group of people.The Marihuana Tax Act of 1937 was a federal law that placed a tax on the sale, possession, and transportation of marijuana. The act was passed by Congress and signed into law by President Franklin D. Roosevelt. The law was not an outright ban on marijuana, but the tax and regulations it imposed effectively made it illegal to possess or sell the drug. The law was initially proposed as a way to raise revenue and regulate the sale of marijuana, which was primarily used for medicinal and industrial purposes at the time. However, it was also driven by a growing social and political movement to criminalize the drug, fueled by claims that it was associated with crime and immorality. The act was later ruled unconstitutional in 1969, but it was replaced by the Controlled Substances Act of 1970, which classified marijuana as a Schedule I drug with no accepted medical use, and thus effectively banned it on a federal level.

Prior to the passage of the Marihuana Tax Act of 1937, several states in the United States had laws in place that restricted the use of cannabis or marijuana. For example, California passed the first state law in 1913 that prohibited the sale, possession, and use of marijuana. Other states such as Texas, Wyoming, and Louisiana also passed similar laws in the following years.

Also, many cities and municipalities had passed ordinances that targeted marijuana use, often in response to perceived social and moral concerns. These laws were largely directed at immigrants, particularly Mexicans, who were thought to have brought the drug with them to the U.S.

You Mention Mexicans being a useful tool for prohibitionists, what about African Americans?

During the 1910s and 1920s, millions of Mexicans immigrated to the United States to escape the violence of the Mexican Revolution and to find work. Many of these immigrants used marijuana as a way to cope with the stresses of life in the U.S. This led to stereotypes of Mexicans as "marijuana smokers" and the drug being associated with lower-class, criminal, and immoral behavior.

This sentiment was further fueled by the press, who sensationalized crime and drug use, particularly among minorities. In this way, the criminalization of marijuana was used as a tool of social control and to justify discrimination and repression against Mexican and Black communities..

What was the effect of these policies on black and brown communities?

We know the well documented effects that marijuana prohibition has had on our communities in terms of arrests/incarceration, violence, deaths and financial devastation from lost wages, degradation of our communities, loss of property value etc But not is made of the fact that we also loss access to a very tool that was once a treasured part of our medicine kit. The loss of access to marijuana and Hemp derived products and therapies resulted in diminished health outcomes for communities of color.

How did losing access to cannabis and Hemp negatively affect the health black and brown people?

If you recall, marijuana use recreationally was only employed by a small number of users. Most of the people at that time were using it for medicinal purposes. As mentioned, many of the immigrant Mexicans reported using it to help with “stress”. But it is used as a common pain reliever for migraines, menstrual pains, toothaches, joint pain and many other common ailments.

Black and brown people traditionally have less access to healthcare services for a number of reasons- but mostly due to economics and discriminatory policies.. African Americans with chronic conditions tend to use complementary and alternative medicine at three times the rate of others .

Many of the patients I see in clinics seeking cannabis or CBD for chronic conditions do not have primary care providers and those who do, aren't satisfied with the results. For these people, prior to legalization of Marijuana in some states and the legalization of Hemp products nationally in 2019 there was no solution except suffering through it or trying to obtain medicine on the black market and assuming all of the risks that come along with that

People with poorly managed chronic conditions are at greater risks for depression, sleep disturbances, anxiety, suicidal ideation and decreased life expectancy. In addition, they are at higher risk of development of serious comorbidities and substance use disorders

Have you worked with any patients who you’ve seen cannabis or CBD benefit for conditions where western medicine was failing?

Certainly, its’ well documented that CBD is an effective antiepileptic. There is an FDA approved drug for treatment of certain seizure disorders that only has CBD as an active ingredient (it’s expensive). We have a number of patients who we’ve helped improve the management of their seizures with CBD. We also have a number of people with anxiety who we’ve managed to help get off their prescription drugs by using CBD and implementing some lifestyle changes.

Books you can read about this topic:

  • "The Narcotics Farm: The Rise and Fall of America's First Prison for Drug Addicts" by Joel D. Howell (2008)
  • "Smoke Signals: A Social History of Marijuana - Medical, Recreational and Scientific" by Martin A. Lee (2012)
  • "The War on Drugs: A Failed Experiment" by Ethan A. Nadelmann (2011)
  • "Marijuana: A Short History" by Andrew J. Hathaway (2019)

REFERENCES 

1Cohen A, Vakharia SP, Netherland J, Frederique K. How the war on drugs impacts social determinants of health beyond the criminal legal system. Ann Med. 2022 Dec;54(1):2024-2038. doi: 10.1080/07853890.2022.2100926. PMID: 35852299; PMCID: PMC9302017.

2Kolodny A, Courtwright DT, Hwang CS, Kreiner P, Eadie JL, Clark TW, Alexander GC. The prescription opioid and heroin crisis: a public health approach to an epidemic of addiction. Annu Rev Public Health. 2015 Mar 18;36:559-74. doi: 10.1146/annurev-publhealth-031914-122957. Epub 2015 Jan 12. PMID: 25581144..

3Barner JC, Bohman TM, Brown CM, Richards KM. Use of complementary and alternative medicine for treatment among African-Americans: a multivariate analysis. Res Social Adm Pharm. 2010 Sep;6(3):196-208. doi: 10.1016/j.sapharm.2009.08.001. PMID: 20813333; PMCID: PMC2933406..

4Mills SEE, Nicolson KP, Smith BH. Chronic pain: a review of its epidemiology and associated factors in population-based studies. Br J Anaesth. 2019 Aug;123(2):e273-e283. doi: 10.1016/j.bja.2019.03.023. Epub 2019 May 10. PMID: 31079836; PMCID: PMC6676152.

5Macfarlane GJ, Barnish MS, Jones GT. Persons with chronic widespread pain experience excess mortality: longitudinal results from UK Biobank and meta-analysis. Ann Rheum Dis. 2017 Nov;76(11):1815-1822. doi: 10.1136/annrheumdis-2017-211476. Epub 2017 Jul 21. PMID: 28733474.

6National Research Council (US) Panel on DHHS Collection of Race and Ethnic Data. Eliminating Health Disparities: Measurement and Data Needs. Ver Ploeg M, Perrin E, editors. Washington (DC): National Academies Press (US); 2004. PMID: 25009872.

7 Institute of Medicine (US) Committee on Advancing Pain Research, Care, and Education. Relieving Pain in America: A Blueprint for Transforming Prevention, Care, Education, and Research. Washington (DC): National Academies Press (US); 2011. PMID: 22553896.

8Chronic Pain: In Depth | NCCIH
Website title:National Center for Complementary and Integrative Health
URL:https://www.nccih.nih.gov/health/chronic-pain-in-depth
Date accessed:December 14, 2022.

9Crocq MA. History of cannabis and the endocannabinoid system. Dialogues Clin Neurosci. 2020 Sep;22(3):223-228. doi: 10.31887/DCNS.2020.22.3/mcrocq. PMID: 33162765; PMCID: PMC7605027.

10Piper BJ, Beals ML, Abess AT, Nichols SD, Martin MW, Cobb CM, DeKeuster RM. Chronic pain patients' perspectives of medical cannabis. Pain. 2017 Jul;158(7):1373-1379

Dr. Herve Damas

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