I have been turning over in my head recently the whole phenomenon of the “medical marijuana” movement and I conclude that it is time to discard a pernicious dichotomy.
I believe that the irony of the struggle in New Jersey resides in the statutory name of the not-for-profit corporate dispensaries which the medical marijuana statute creates and which Governor Christie seeks to destroy. The funny thing is that the statute refers to the dispensaries as “Alternate Treatment Centers.” Note the language with its clear reference to the field of complementary and alternative medicine (CAM).
Those Alternative Treatment Centers are what Christie seeks to destroy through his proposal to undo the enacted statute and place all control over supply in the hands of entities that cannot possibly participate in this market for fear of losing their federal funding. It is just so funny: the legislature devised a scheme to let cannabis slip through federal prohibition by making into an alternate treatment and, in order to thwart this plan, Christie is trying to stick it back into the federal regulatory scheme that effectively governs the practice of medicine.
The tension in cannabis control is the dichotomy between “medical use” and non-medical use. Opponents of the concept of “medical marijuana” state that it is simply a front for non-medical use. However, they don’t say “non-medical use.” They say “recreational use.” Or they say “abuse.”
The inner meaning of this language is the dichotomy between medicine and intoxication. The medical/non-medical dichotomy posits what I will call an “alcohol” model of drugs – or an “intoxication” model. The image of use other than for utilitarian purposes, i.e. use that is not intended to solve an acute health problem, is visualized as a form of illicit sensation – a potentially dangerous foray into hedonism. It is a model of unjustified euphoria – a sensation not sanctioned by the authorities. But then, why should non-medical euphoria be justified when society has experienced so much of the intoxicant model, whether as exemplified by alcohol or through unsafe use of other drugs. The intoxicant model is one in which the user seeks oblivion – by consuming to excess, by consuming with the desire for stimulation or impairment to the extent of endangering self and others. The intoxicant model of use is difficult to justify to anyone entrusted with protecting the safety, health and welfare of society.
Enter the model of “alternative treatment.” Instead of being a “medicine,” which cannabis can’t be legally because (a) it is in Schedule I of the Control Substances Act and (b) the FDA has not approved its sale in interstate commerce, or a recreational intoxicant, it is a form of alternative medicine.
This formulation opens the door to the re-characterization of cannabis as something that simply makes a person feel better. Like a painkiller. It relieves pain. Maybe it relieves stress. It could be characterized not as a medicine nor as an intoxicant but as a therapeutic agent if used under the right circumstances i.e a conducive societal context.
The therapeutic use model must contend with two dueling models: the medical model, which is the premise for drug prohibition (since any use other than medical use is criminal), and the intoxicant model, which remains the dominant model of drugs in popular culture – and remains the nightmare image of self-impairment and destruction that justifies drug prohibition. The task at hand then may be to retire the intoxicant model. This approach may be unpopular with the population that projects the model of cannabis ‘inebriation,’ e.g stoner culture, as a viable option, but it may be the necessary compromise with the surrounding bureaucratic culture of accounting that is charged with assessing risk and figuring out who pays for the mess caused by intoxicated people.
I would like to think that this analysis discloses a deeper stream in the Christie administration’s attempt to subvert New Jersey’s medical marijuana statute. It is ironic that the Governor of New Jersey has launched an attack on a statute that explicitly describes cannabis as an alternative medicine, a term that implicates an alternative paradigm of psychoactive substance use – a “third way” out of the intoxicant-prohibition impasse. This model of “therapeutic use” as an alternative to both drug prohibition and to intoxication is the real, if perhaps unintended, target of the Christie administration.