An Insider's Take on Medical Cannabis and the Social Justice Thing

Jeremy Unruh
General Counsel and Chief Compliance Officer, PharmaCann LLC (IL & NY)


"Congratulations on not being a criminal," I tell our medical cannabis patients. 

I don't say that to everybody, of course, because not everybody would appreciate the ironic humor of the statement.  But, on the infrequent occasion that I run into a registered patient with whom I can have some light banter, I sometimes send people out the door with this joviality.

You see the reaction in their eyes.  For most, its the first time they've truly stopped to appreciate that they are finally duly-registered medical marijuana patients under Illinois law, and as a result, are no longer subject to the state criminal anti-possession drug laws that have existed for nearly a century in this country.  Yes, there are restrictions on when, where, and how an Illinois MMJ patient may transport, possess, and use medical cannabis, but, as a general proposition, these people are now law-abiding citizenry, able to follow society's rules to the letter.  Some of these patients have been engaged in the adult-use of cannabis for years, risking stiff penalties -- including incarceration -- to use cannabis to relieve physical symptoms in an otherwise responsible way.

I know, I know.  Cannabis is a controlled substance under federal law, and is, by definition, illegal to possess and sell, but the "G" (as in Government) has made it clear that under the current administration, it does not intend to enforce federal criminal law against those persons and businesses that are appropriately engaged in the commerce of medical marijuana pursuant to state law, absent exceptional circumstances. 

The Social Justice Thing

Which brings up the social justice issue, something that, given my background as a prosecuting attorney in one of the nation's busiest criminal justice systems, is near and dear to my heart.  In the universe of cannabis, I probably identify more closely with this slice of our mission than any other:  I don't have a close family member with a qualifying condition.  I don't work in the hospice or healthcare industry watching waves of people struggle with pain, nausea, spasticity, or some other condition for which traditional medicine is not a viable option. 

I did, however, prosecute literally thousands of misdemeanor and felony cannabis and other drug cases originating in some of the most blighted, underprivileged neighborhoods in this country of ours.  I watched young person after young person, usually African-American or Hispanic, some Eastern European, trotted out of every lockup in Chicago to stand before a judge and answer for a few shekels worth of cannabis.

What's the cost?

Two officers to book (4 man-hours); One officer a day's pay to come to court on two dates (let's call that 12 man-hours), not to mention the forcible arrest of the defendant and the two days of work he or she has to miss, court personnel, file preparation time, attorney workup, and so forth.  You can do the math.  All for the value of a couple of baseball cards.

Leaving aside the huge financial burden, as well as the impact that an arrest or conviction can have on a young person, regardless of socio-economic status,  what makes the social justice issue more disturbing to me, is that our present understanding of cannabis epidemiology may have been biased by the influence of the criminal justice process.

A study by the Substance Abuse and Mental Health Services Administration suggests that less than one in five who are in treatment centers for cannabis were admitted voluntarily or by somebody else. (note 1).  An overwhelming number, some 52 percent, were referred by the criminal justice system.  This means that the addiction rates that naysayers use as a reason to discourage the adoption of medical cannabis (somewhere around 9-10%) may be overblown because a large percentage of people who seek treatment for cannabis addiction might actually be electing to enter a treatment program as a last resort over more severe criminal punishment.  If those people are counted as "addicts" because they enter a court-imposed addiction treatment rather than face jail, then the numbers may be unreliable and the risks of addiction are far less understood than we previously believed them to be.

This isn't fair to the defendant who is caught between the Scylla and Charybdis, forced to choose the claim of addiction over incarceration.  Don't get me wrong, our modern drug courts are a solid way for the criminal justice system to modify its paradigm and change its response to the drug-addicted defendant.  I have no beef with these laudable efforts.  I do, however, sympathize with the thousands of Illinois patients who want valid and reliable science to support their decision-making process.  What are the benefits of medical cannabis?  What are the risks?  People who are new to medical cannabis deserve accurate answers for these questions, especially an accurate understanding of the risks.  Furnishing solid science to consumers is a social justice issue, too.  Reliable research using people engaged in the lawful use of medical cannabis will accomplish this goal, not tallying the people walking out of a courthouse.  So, to the card-carrying registered patient or designated caregiver, I raise my hand in salute and say, "Congratulations on not being a criminal."

note 1:  Substance Abuse and Mental Health Services Administration, Center for Behavioral Health Statistics and Quality. Treatment Episode Data Set (TEDS): 2003-2013. National Admissions to Substance Abuse Treatment Services. BHSIS Series X-XX, HHS Publication No. (SMA) XX-XXXX. Rockville, MD: Substance Abuse and Mental Health Services Administration, 2015.