On January 30, 2013, the Senate of the Czech Republic approved a bill by a vote of 67-2 to allow medical marijuana throughout the country. Although support for the bill was high, the law does little to support patients who need medical marijuana. That is the frustration of Zdenek Majzlik, a 67-year-old man who grows marijuana to treat his 46-year-old daughter’s multiple sclerosis. Majzlik was a strong supporter of the bill and fought for lawmakers to allow medical marijuana; but he is still fighting for safe access.
The bill established strict consumer regulations; no patient under 18 can use medical marijuana, heath insurance companies are banned from covering the cost of medical marijuana, and patients are limited to a little over one ounce per month. Furthermore, the bill currently prohibits growing marijuana in the Czech Republic and only allows four specific strains to be imported from the Netherlands. The result is an extremely limited market and high prices. The Czech National Drug Coordinator said that the situation is unacceptable, and the restrictions on obtaining medical marijuana are “unnecessarily limiting and discriminating.”
Now the government is taking another step against medical marijuana patients. While small independent growers like Majzlik used to be off the police radar, recently the police have raided about 100 stores suspected of selling supplies for growing marijuana. The sweep is in conjunction with investigating about 45 people suspected of illegal marijuana growing or distributing.
The frustrations faced by Mr. Majzlik are similar to the dilemma of many medical marijuana patients throughout the United States.
That I face five years in jail for trying to provide something the current medicine can’t do is insane. I don’t want to be a hero. I am breaking the law, and that’s a problem for me. I don’t think I’m a criminal.
On Tuesday, in pharmacies across the Czech Republic, medical marijuana was made available to patients suffering from cancer, Parkinson's disease, multiple sclerosis, or psoriasis. Marijuana is available by prescription only, and must be imported from the Netherlands or Israel since a cultivation program is not yet included in the law.
The Czech Senate overwhelmingly voted in favor of a medical marijuana bill earlier this year, and President Vaclav Klaus signed the bill into law on February 15.
The law does not mandate that medical marijuana be covered by health insurance nor does it allow for home cultivation by patients. Regardless, the country has some of the most lenient marijuana laws in Europe. Possession of five or less plants is merely a misdemeanor, and fines for possession of 15 grams or less are on par with parking citations.
The incoming Dutch government has rejected a proposal for a “wietpas” or “weed pass,” a compulsory registration for anyone using the country’s famous marijuana cafes. The proposal would have limited access to the cafes to Dutch residents. The mayors of the Dutch cities of Amsterdam, The Hague, Rotterdam, and Utrecht expressed opposition to the proposal, citing a probable increase in black-market street dealing if the measure were implemented. Instead, the coalition government produced an agreement, which, although lacking a registration system, would still ostensibly allow only Dutch residents access to the cafes.
The weed pass proposal was apparently connected with complaints of “drug tourism” in the Netherlands. Tourists from neighboring countries such as Germany, Belgium, and France are a daily sight and apparently a major source of revenue for the Dutch “coffee shops.” Use of the drug by Dutch citizens is actually relatively rare, even in comparison with residents of other European countries, with less than 6% of adults having used it in the past year. Ard van der Steur, a member of parliament for the right-wing People’s Party for Freedom and Democracy, described the current situation as “an incredible criminal industry that we need to get rid of,” and complained that “we now function as a supplier of drugs for the rest of Europe.” Tahira Limon, a spokeswoman for the city of Amsterdam, stated however that marijuana is not a serious problem for the country. “The problems we have with substance abuse are almost always related to alcohol,” she said.
How much, or even if, this new revised restriction will be enforced is still in question. The coalition’s new policy agreement states that it will be “if necessary phased in,” and that details of enforcement will be determined “in discussion with the local councils concerned.” Some cafe owners say that they do not expect an actual change in policy, while others complain that the policy is still unclear.
Marijuana is still technically illegal in the Netherlands, as the country is a signatory to treaties such as the UN Single Convention on Narcotic Drugs, requiring the prohibition of cannabis along with several other drugs. In practice, however, small-scale marijuana distribution and possession is tolerated in licensed cafes in several cities, including Amsterdam. This policy has been in place since 1972, when it was recommended by a government commission.
In its official response to the AMA’s recent call for a review of marijuana’s status as a Schedule I drug (barring any medical use) under federal law, the White House Office of National Drug Control Policy stated that it would defer to "the FDA's judgment that the raw marijuana plant cannot meet the standards for identity, strength, quality, purity, packaging and labeling required of medicine."
While we’re not used to factual accuracy from ONDCP, in this case they’re wrong not once, but twice.
First, there is absolutely no reason that plant medicines can’t be standardized and controlled for purity and potency. Indeed, the Netherlands has been doing just that for years, with medical marijuana distributed in Dutch pharmacies that is “of pharmaceutical quality and complies with the strictest requirements,” according to the Dutch government.
Second, the FDA has never said that a natural plant product can’t be a medicine. Indeed the agency has a lengthy “Guidance for Industry: Botanical Drug Products,” specifically designed to aid developers of plant medicines. The document not only doesn’t rule out plants as medicines, it even states, “In the initial stage of clinical studies of a botanical drug, it is generally not necessary to identify the active constituents or other biological markers or to have a chemical identification and assay for a particular constituent or marker.” Given that the active components of marijuana are already well-known and extensively researched, marijuana is well ahead of where the FDA says plant products need to be to start the process of seeking FDA licensing.
Yes, the FDA did put out a press release in 2006 saying that “smoked marijuana” had not been shown to be a safe and effective medicine. That statement was utterly unscientific, as we pointed out at the time, but it was absolutely not a declaration that the plant could never be a medicine.
Many people are at least vaguely aware that government-sanctioned medical marijuana programs exist in Canada and the Netherlands. But few Americans are aware that another of America's strongest allies, Israel, also has a national medical marijuana program. And, according to a translation posted by MAPS of a recent article in the Israeli newspaper Maariv, that program is growing.
Three hundred patients are now enrolled, representing a 1,400% increase in new permissions to use medical marijuana in the last two years, according to the paper. Strikingly, the program includes not only the obvious indications like neuropathic pain or nausea and vomiting related to treatments for cancer or HIV/AIDS, but conditions like post-traumatic stress disorder that are often not included in U.S. medical marijuana laws, though there is reason to believe that marijuana may be helpful for at least some PTSD patients.
Meanwhile, seven German patients recently became the first in their country to receive whole marijuana for medical use with government approval. As the rest of the world starts to enter the 21st century on this issue, will the U.S. continue to be stuck in 1937?
Germany is about to become the fifth country to allow at least some patients to use natural marijuana as medicine. According to a report from the International Association for Cannabis as Medicine, the German government recently notified four patients that they would be allowed to receive medical marijuana produced under the Dutch government's medical marijuana program. The German program remains limited to special cases.
Other German patients have been allowed to use a liquid extract made from Dutch cannabis, but for some patients the extract proved unsatisfactory. The patients are expected to receive their supply of whole marijuana around mid-January.
Other than the Netherlands, nations that have some sort of medical marijuana program sanctioned by their national governments -- with varying levels of restrictions and limitations -- include Canada and Israel. Oh, and the U.S., which still provides medical marijuana to a handful of surviving patients in a program that was closed to new enrollment in 1992.
The Dutch have evolved a mostly workable but somewhat contradictory system for handling marijuana: While technically illegal, possession and sale of small amounts through regulated "coffee shops" have been tolerated since the mid-'70s. This has effectively separated the retail market for marijuana from more dangerous drugs like cocaine and heroin, but because marijuana cultivation remains banned, coffee shops have no legitimate source for their product.
A group of 30 Dutch mayors has now proposed the logical solution: a system of government-licensed marijuana cultivation. While the present conservative government of the Netherlands has moved to reduce the number of coffee shops, the mayors argue that such a move is likely to be counterproductive.
In the marijuana reform movement, one of the comments I often overhear in conversations, see posted in online message forums, or read in blog comments relates to the Netherlands and their treatment of marijuana. "Treat marijuana like the Netherlands does" seems to be the rallying cry for lots of misinformed people.
Jeffrey Stinson recently did a short piece on how marijuana is treated in the Netherlands for USA Today. Though brief, the story zeroes in on one important fact: Marijuana in the Netherlands is illegal; the government simply chooses to ignore its sale and use.
I respect that the Netherlands treats marijuana more in accordance with the potential harms than America does, but I still strongly believe that as Americans we should work toward creating sensible policies to tax and regulate marijuana rather than making a conscious effort to ignore it. Let's look for solutions, not stopgaps.
What do you think?