Social Justice and Medical Equity through Federal Legalization of Marijuana

Main Article Content

Tija M. Passley John M. Purcell German Torres Joerg R. Leheste

Abstract

Most Americans are living with state-sanctioned cannabis jurisdiction permitting medicinal, and often, recreational use. Yet, cannabis and its cannabinoids remain on schedule-I of the controlled substances act (CSA), imposing hurdles to much needed research and promulgating outdated ‘War on Drugs’ policies and their disproportionate impact on minorities. Recent advances by the current government to decriminalize past federal cannabis possession convictions and the encouragement to State Governors to follow suit are within the current political climate and public opinion but fall short during times of an ever- faster expansion of cannabis legislation and access by the individual states. Opposing views on federal cannabis legalization have precipitated an indeterminate situation between federal and state legislation prompting inconsistent decision-making, social injustice, and health inequities across the country. The latter can be exemplified by the inconsistencies of qualifying conditions and availability of cannabis for medicinal use. Now, under the new 118th U.S. Congress, it becomes ever more important to re-focus on legislative opportunities such as the ‘Marijuana Opportunity Reinvestment and Expungement (MORE) Act of 2021’ which had been previously passed by the House of Representatives on April 1st, 2022, under the 117th Congress (2021-22). This bill aims to de-schedule and decriminalize use, possession, distribution, sale, and production of medical cannabis on the federal level. Through establishing cannabis business equity and loan programs, it seeks to promote social justice for communities disproportionately affected by the ‘War on Drugs’. This health policy research brief provides a comprehensive view of stakeholder perspectives and positions, as well as potential benefits and drawbacks - all with a historical perspective.

Keywords: War on Drugs, Decriminalization, Societal Equity, Medical Equity, Congressional Bill, U.S. Senate, House of Representatives, U.S. Congress, Cannabis (Marijuana), Marijuana

Article Details

How to Cite
PASSLEY, Tija M. et al. Social Justice and Medical Equity through Federal Legalization of Marijuana. Medical Research Archives, [S.l.], v. 11, n. 3, mar. 2023. ISSN 2375-1924. Available at: <https://esmed.org/MRA/mra/article/view/3697>. Date accessed: 09 oct. 2024. doi: https://doi.org/10.18103/mra.v11i3.3697.
Section
Research Articles

References

1. National Conference of State Legislatures. State Medical Marijuana Laws. 2021. Accessed December 21, 2022. https://www.ncsl.org/research/health/state-medical-marijuana-laws.aspx.
2. Cannabis Business Times. How Many States Have Legalized Adult Recreational Cannabis? 2021. Accessed December 21, 2022. https://www.cannabisbusinesstimes.com/article/how-many-states-have-legalized-adult-use-cannabis/.
3. The United States Department of Justice. Justice Department Announces Update to Marijuana Enforcement Policy. 2013. Accessed December 21, 2022. https://www.justice.gov/opa/pr/justice-department-announces-update-marijuana-enforcement-policy.
4. The United States Drug Enforcement Administration. Drug Scheduling. 2021. Accessed December 21, 2022. https://www.dea.gov/drug-information/drug-scheduling.
5. Library of Congress. Marijuana Opportunity Reinvestment and Expungement Act. 2021. Accessed December 21, 2022. https://www.congress.gov/bill/117th-congress/house-bill/3617?q=%7B%22search%22%3A%5B%22h.r.3617%22%2C%22h.r.3617%22%5....
6. Constitution Annotated. Analysis and Interpretation of the U.S. Constitution. Constitution of the United States: The Preamble. 2011. Accessed December 21, 2022. https://constitution.congress.gov/constitution/preamble/.
7. City of Oakland. Oakland Cannabis Equity Program. 2022. Accessed December 21, 2022. https://www.oaklandca.gov/projects/cannabis-equity-program.
8. City of Oakland. Loan & Grant Program Elevate Impact Oakland. 2022. Accessed December 21, 2022. https://www.oaklandca.gov/services/elevate-impact-oakland-loan-grant-progam.
9. Los Angeles Municipal Code. SEC. 104.20. SOCIAL EQUITY PROGRAM. 2017. Accessed December 21, 2022. https://codelibrary.amlegal.com/codes/los_angeles/latest/lamc/0-0-0-312273.
10. Cannabis Control Commission. Commonwealth of Massachusetts. Social Equity Program. 2022. Accessed December 21, 2022. https://masscannabiscontrol.com/equity-programs/.
11. Richard Nixon Foundation. President Nixon Declares Drug Abuse “Public Enemy Number One.” 2016. Accessed December 21, 2022. https://youtu.be/y8TGLLQlD9M.
12. The Editors of Encyclopedia Britannica. War on Drugs. United States History. 2018. Accessed December 21, 2022. https://www.britannica.com/topic/war-on-drugs.
13. Moore LD, Elkavich A. Who's Using and Who's Doing Time: Incarceration, the War on Drugs, and Public Health. American Journal of Public Health. 2008;98(Suppl 1):S176-S180. doi: 10.2105/AJPH.98.Supplement_1.S176.
14. CNN Politics. Biden Pardons All Federal Offenses of Simple Marijuana Possession in First Major Steps Toward Decriminalization. (2022). Accessed: 12-22-2022: https://www.cnn.com/2022/10/06/politics/marijuana-decriminalization-white-house-joe-biden/index.html.
15. Carliner H, Brown QL, Sarvet AL, Hasin DS. Cannabis use, Attitudes, and Legal Status in the U.S.: A Review. Preventive Medicine. 2017;104:13-23. doi: 10.1016/j.ypmed.2017.07.008.
16. Gallup Inc. Support for Legal Marijuana Holds at Record High of 68%. (2021). Accessed: 12-22-2022: https://news.gallup.com/poll/356939/support-legal-marijuana-holds-record-high.aspx.
17. The United States Department of Justice. Justice Department Issues Memo on Marijuana Enforcement. (2018). Accessed: 12-22-2022: https://www.justice.gov/opa/pr/justice-department-issues-memo-marijuana-enforcement.
18. Financial Services for Marijuana Businesses. Congressional Research Service. (2019). Accessed: 12-22-2022: http://2019.
19. Colorado Department of Revenue. Marijuana Tax Reports. (2021). Accessed: 12-22-2022: https://cdor.colorado.gov/data-and-reports/marijuana-data/marijuana-tax-reports.
20. California Department of Tax and Fee Administration. Cannabis Tax Revenues. (2019). Accessed: 12-22-2022: https://www.cdtfa.ca.gov/dataportal/charts.htm.
21. Global Newswire. BDSA Reports Global Cannabis Sales Exceeded $21 Billion in 2020; Forecasts $55.9 Billion by 2026. (2021). Accessed: 12-21-2022: https://www.globenewswire.com/news-release/2021/03/02/2185408/0/en/BDSA-Reports-Global-Cannabis-Sales-Exceeded-21-Bil....
22. Cash MC, Cunnane K, Fan C, Romero-Sandoval EA. Mapping cannabis potency in medical and recreational programs in the United States. Largent-Milnes T, ed. PLOS ONE. 2020;15:e0230167. doi: 10.1371/journal.pone.0230167.
23. U.S. Food and Drug Administration. FDA Regulation of Cannabis and Cannabis-Derived Products, Including Cannabidiol (CBD): Communication & Regulatory Resources. (2022). Accessed: 12-22-2022:
https://www.fda.gov/news-events/public-health-focus/fda-regulation-cannabis-and-cannabis-derived-products-including-cannabidiol-cbd
24. U.S. Congress. H.R.8454 - 117th Congress ( 2021-2022): Medical Marijuana and Cannabidiol Research Expansion Act. (2022). Accessed: 12-22-2022: https://www.congress.gov/bill/117th-congress/house-bill/8454.
25. Purcell JM, Passley TM, Leheste JR. The cannabidiol and marijuana research expansion act: Promotion of scientific knowledge to prevent a national health crisis. Lancet Reg Health Am. 2022 Jul 13;14:100325. doi: 10.1016/j.lana.2022.100325. PMID: 36777382; PMCID: PMC9903742.
26. Rock EM, Parker LA. (2021). Constituents of Cannabis Sativa. Advances in Experimental Medicine and Biology, 1264:1-13. doi: 10.1007/978-3-030-57369-0_1.
27. National Institute on Drug Abuse. (2020). Is Marijuana Safe and Effective as Medicine? Accessed: 12-22-2022: https://nida.nih.gov/publications/research-reports/marijuana/marijuana-safe-effective-medicine.
28. Russo E. (2008). Cannabinoids in the Management of Difficult to Treat Pain. Therapeutics and Clinical Risk Management, 4:245-259. doi: 10.2147/tcrm.s1928.
29. U.S. Food and Drug Administration. Office of the Commissioner. (2018). FDA approves first drug comprised of an active ingredient derived from marijuana to treat rare, severe forms of epilepsy. Accessed: 12-22-2022: https://www.fda.gov/news-events/press-announcements/fda-approves-first-drug-comprised-active-ingredient-derived-marijuana-treat-rare-severe-forms.
30. National Institute on Drug Abuse. (2022). Overdose Death Rates. Accessed: 12-22-2022: https://nida.nih.gov/research-topics/trends-statistics/overdose-death-rates.
31. Mattson CL, Tanz LJ, Quinn K, Kariisa M, Patel P, Davis NL. (2021). Trends and Geographic Patterns in Drug and Synthetic Opioid Overdose Deaths — United States, 2013-2019. MMWR Morbidity and Mortality Weekly Report, 70:202-207. doi: 10.15585/mmwr.mm7006a4.
32. Modesto-Lowe V, Bojka R, Alavarado C. (2018). Cannabis for Peripheral Neuropathy: The Good, the Bad, and the Unknown. Cleveland Clinic Journal of Medicine, 85:943-949. doi: 10.3949/ccjm.85a.17115.
33. Rog DJ, Nurmikko TJ, Friede T, Young CA. (2005). Randomized, Controlled Trial of Cannabis-Based Medicine in Central Pain in Multiple Sclerosis. Neurology, 65:812-819. doi: 10.1212/01.wnl.0000176753.45410.8b.
34. Wallace MS, Marcotte TD, Umlauf A, Gouaux B, Atkinson JH (2015). Efficacy of Inhaled Cannabis on Painful Diabetic Neuropathy. The Journal of Pain, 16, 616-627. doi: 10.1016/j.jpain.2015.03.008.
35. Wilsey B, Marcotte TD, Deutsch R, Gouaux B, Sakai S, Donaghe H (2013). Low Dose Vaporized Cannabis Significantly Improves Neuropathic Pain. The Journal of Pain, 14, 136-148. doi: 10.1016/j.jpain.2012.10.009.
36. National Institutes of Health (NIH) (2012). Greek Medicine - the Hippocratic Oath. Accessed: 12-23-2022. https://www.nlm.nih.gov/hmd/greek/greek_oath.html.
37. Boehnke KF, Gangopadhyay S, Clauw DJ, Haffajee RL (2019). Qualifying Conditions of Medical Cannabis License Holders in the United States. Health Affairs, 38, 295-302. doi: 10.1377/hlthaff.2018.05266.
38. Rotter A, Bayerlein K, Hansbauer M, et al. (2013). CB1 and CB2 Receptor Expression and Promoter Methylation in Patients with Cannabis Dependence. European Addiction Research, 19, 13-20. doi: 10.1159/000338642.
39. Morgan CJA, Page E, Schaefer C, et al. (2013). Cerebrospinal Fluid Anandamide Levels, Cannabis Use and Psychotic-Like Symptoms. British Journal of Psychiatry, 202, 381-382. doi: 10.1192/bjp.bp.112.121178.
40. Testai FD, Gorelick PB, Aparicio HJ, et al. (2022). Use of Marijuana: Effect on Brain Health: A Scientific Statement from the American Heart Association. Stroke, 10, 2022. doi: 10.1161/str.0000000000000396.
41. Hurd YL, Manzoni OJ, Pletnikov MV, Lee FS, Bhattacharyya S, Melis M (2019). Cannabis and the Developing Brain: Insights into Its Long-Lasting Effects. Journal of Neuroscience, 39, 8250-8258. doi: 10.1523/jneurosci.1165-19.2019.
42. Higuera-Matas A, Ucha M, Ambrosio E (2015). Long-Term Consequences of Perinatal and Adolescent Cannabinoid Exposure on Neural and Psychological Processes. Neuroscience & Biobehavioral Reviews, 55, 119-146. doi: 10.1016/j.neubiorev.2015.04.020.
43. Renard J, Rushlow WJ, Laviolette SR (2018). Effects of Adolescent THC Exposure on the Prefrontal GABAergic System: Implications for Schizophrenia-Related Psychopathology. Frontiers in Psychiatry, 9, 1-13. doi: 10.3389/fpsyt.2018.00281.
44. Albaugh MD, Ottino-Gonzalez J, Sidwell A, et al. (2021). Association of Cannabis Use During Adolescence with Neurodevelopment. JAMA Psychiatry, 78, 1031. doi: 10.1001/jamapsychiatry.2021.1258.
45. Gillespie NA, Neale MC, Bates TC, et al. Testing associations between cannabis use and subcortical volumes in two large population-based samples. Addiction. 2018;113:1661-1672. doi: 10.1111/add.14252.
46. Chye Y, Suo C, Lorenzetti V, et al. Cortical Surface Morphology in Long-Term Cannabis Users: A multi-Site MRI study. European Neuropsychopharmacology. 2019;29:257-265. doi: 10.1016/j.euroneuro.2018.11.1110.
47. Way of Leaf. Medical Cannabis States and Their Qualifying Conditions. Accessed December 23, 2022. https://wayofleaf.com/mmj-cards/state/medical-marijuana-legal-states.
48. Lucas P. Cannabis as an Adjunct to or Substitute for Opiates in the Treatment of Chronic Pain. Journal of Psychoactive Drugs. 2012;44:125-133. doi: 10.1080/02791072.2012.684624.
49. National Conference of State Legislatures. Cannabis & Employment Laws. Accessed December 23, 2022. https://www.ncsl.org/research/labor-and-employment/cannabis-employment-laws.aspx.
50. Society for Human Resource Management (SHRM). Workplace Drug Testing: Can Employers Still Screen for Marijuana? Accessed December 23, 2022. https://www.shrm.org/resourcesandtools/legal-and-compliance/state-and-local-updates/pages/can-employers-still-test-for-marijuana.aspx.
51. Centers for Disease Control and Prevention. Opioid Data Analysis and Resources. CDC’s Response to the Opioid Overdose Epidemic. CDC. Accessed December 23, 2022. https://www.cdc.gov/opioids/data/analysis-resources.html.
52. Lucas CJ, Galettis P, Schneider J. The Pharmacokinetics and the Pharmacodynamics of Cannabinoids. British Journal of Clinical Pharmacology. 2018;84:2477-2482. doi: 10.1111/bcp.13710.
53. Vigil JM, Stith SS, Adams IM, Reeve AP. Associations between medical cannabis and prescription opioid use in chronic pain patients: A preliminary cohort study. PLoS One. 2017;12:e0187795. doi: 10.1371/journal.pone.0187795.
54. Radhakrishnan R, Wilkinson ST, D'Souza DC. Gone to Pot - a Review of the Association Between Cannabis and Psychosis. Frontiers in Psychiatry. 2014;5:54. doi: 10.3389/fpsyt.2014.00054.
55. Forti MD, Iyegbe C, Sallis H, et al. Confirmation that the AKT1 (rs2494732) Genotype Influences the Risk of Psychosis in Cannabis Users. Biological Psychiatry. 2012;72:811-816. doi: 10.1016/j.biopsych.2012.06.020.
56. Caspi, A., Moffitt, T. E., Cannon, M., et al. (2005). Moderation of the Effect of Adolescent-Onset Cannabis Use on Adult Psychosis by a Functional Polymorphism in the Catechol-O-Methyltransferase Gene: Longitudinal Evidence of a Gene X Environment Interaction. Biological Psychiatry, 57, 1117-1127. doi: 10.1016/j.biopsych.2005.01.026.
57. FBI. (2019). 2019 Crime in the United States. Accessed: 12-23-2022. https://ucr.fbi.gov/crime-in-the-u.s/2019/crime-in-the-u.s.-2019/topic-pages/persons-arrested.
58. Federal Bureau of Prisons. (2019). BOP Statistics: Inmate Offenses. Accessed: 12-23-2022. https://www.bop.gov/about/statistics/statistics_inmate_offenses.jsp.
59. Federal Register. (2018). The Daily Journal of the U.S. Government. Annual Determination of Average Cost of Incarceration. Accessed: 12-23-2022. https://www.federalregister.gov/documents/2018/04/30/2018-09062/annual-determination-of-average-cost-of-incarceration.
60. Trust for America's Health. (2021). The Impact of Chronic Underfunding on America's Health System: Trends, Risks, and Recommendations, 2021. Accessed: 12-23-2022. https://www.tfah.org/wp-content/uploads/2021/05/2021_PHFunding_Fnl.pdf.
61. The Century Foundation. (2020). Closing America’s Education Funding Gaps. Accessed: 12-23-2022. http://2020.
62. Beckett, K., & Herbert, S. (2009). The Consequences and Costs of Marijuana Prohibition. Accessed: 12-23-2022. https://lsj.washington.edu/research/publications/katherine-beckett-and-steve-herbert-2008-consequences-and-costs-marijuana.
63. Ammerman, S., Ryan, S., & Adelman, W. P. (2015). The Impact of Marijuana Policies on Youth: Clinical, Research, and Legal Update. Pediatrics, 135, 769-785. doi: 10.1542/peds.2014-4147.
64. Harpin, S. B., Brooks-Russell, A., Ma, M., James, K. A., & Levinson, A. H. (2017). Adolescent Marijuana Use and Perceived Ease of Access Before and After Recreational Marijuana Implementation in Colorado. Substance Use & Misuse, 53, 451-456. doi: 10.1080/10826084.2017.1334069.
65. Grucza, R. A., Vuolo, M., Krauss, M. J., et al. (2018). Cannabis Decriminalization: A Study of Recent Policy Change in Five U.S. States. International Journal of Drug Policy, 59, 67-75. doi: 10.1016/j.drugpo.2018.06.016.
66. National Institute on Drug Abuse. (2021). Cannabis (Marijuana) Potency. National Institute on Drug Abuse. Accessed: 12-23-2022. https://nida.nih.gov/research-topics/marijuana/cannabis-marijuana-potency.
67. National Academies of Sciences, Engineering, and Medicine, Health and Medicine Division, Board on Population Health and Public Health Practice. The Health Effects of Cannabis and Cannabinoids: The Current State of Evidence and Recommendations for Research. Challenges and Barriers in Conducting Cannabis Research. 2017. Accessed December 23, 2022. https://www.ncbi.nlm.nih.gov/books/NBK425757/.
68. Parker KA, Di Mattia A, Shaik F, et al. Risk Management Within the Cannabis Industry: Building a Framework for the Cannabis Industry. Financial Markets, Institutions & Instruments. 2019;28:3-55. doi: 10.1111/fmii.12104.
69. Kavousi P, Giamo T, Arnold G, et al. What do we Know About Opportunities and Challenges for Localities from Cannabis Legalization? Review of Policy Research. 2021;17:2021. doi: 10.1111/ropr.12460.
70. Justia. U.S. Supreme Court. James v. United States, 366 U.S. 213 (1961). 1961. Accessed December 23, 2022. https://supreme.justia.com/cases/federal/us/366/213/.
71. Congressional Research Service. The Application of Internal Revenue Code Section 280E to Marijuana Businesses: Selected Legal Issues. 2021. Accessed December 23, 2022. https://crsreports.congress.gov/product/pdf/R/R46709.
72. Congressional Research Service. Marijuana and Federal Tax Law: In Brief. 2015. Accessed December 23, 2022. https://crsreports.congress.gov/product/pdf/R/R44056/3.
73. National Bureau of Economic Research. Has the Paycheck Protection Program Succeeded? 2020. Accessed December 23, 2022. https://www.nber.org/papers/w28032.
74. U.S. Small Business Administration. Paycheck Protection Program Borrower Application Form. 2021. Accessed December 23, 2022. https://www.sba.gov/document/sba-form-2483-ppp-first-draw-borrower-application-form.
75. The U.S. Department of Justice Archives. 2101. Money Laundering Overview. 2015. Accessed December 23, 2022. https://www.justice.gov/archives/jm/criminal-resource-manual-2101-money-laundering-overview.
76. USA Today. As More Marijuana Dispensaries are Targeted by Robbers, SAFE Banking Act Lingers in Congress. 2022. Accessed December 23, 2022. https://www.usatoday.com/story/money/business/2022/03/26/pot-shop-robberies-washington-us/7155149001/?gnt-cfr=1.
77. Library of Congress. H.R.1996 - SAFE Banking Act of 2021. 2021. Accessed December 23, 2022. https://www.congress.gov/bill/117th-congress/house-bill/1996.
78. Tax Foundation. A Road Map to Recreational Marijuana Taxation. 2020. Accessed December 23, 2022. https://taxfoundation.org/recreational-marijuana-tax/.