Doobie No Harm

Doctors and the War on Drugs

Why is it that when you go to your doctor to ask about medical cannabis, or tell them about your medical usage, hoping to integrate it into your care, they don’t seem to know much about it? The sensible dictum to “discuss your medical cannabis use with your doctor” collides with the grim reality that when you do, it is rare that anything helpful occurs. At this point in history, most doctors are in favor of, or at least not opposed to, legal access to medicinal cannabis. But, as a profession, we know very little about it and aren’t good at discussing it with patients.

It wasn’t always so. Throughout the second half of the nineteenth century, right up until 1937, when cannabis became effectively prohibited in the United States by the Marihuana Tax Act, doctors routinely prescribed cannabis tinctures and considered it to be an effective, mainstream medicine. It wasn’t controversial. The American Medical Association, back when it was a helpful organization, testified against the criminalization of cannabis.

Cannabis was widely prescribed by American doctors in the late 1800’s and early 1900’s.

So how did American physicians go from being ardent proponents of, and experts in, cannabis medicine in the 1930s to their current black hole of knowledge about even the basics of medical cannabis?

The passage of the Marihuana Tax Act in 1937 made it virtually impossible to perform research or to treat patients with cannabis. Without lived experience, doctors and patients alike are susceptible to manipulation and propaganda. Harry Anslinger, the mercurial director of the Federal Bureau of Narcotics, waged a campaign to force doctors into allegiance with the government’s hateful and restrictive position against cannabis. Anslinger, with the help of the Hearst newspaper empire, waged a decades long smear campaign against cannabis, exploiting racist tropes and irrational fears about Blacks and Mexicans.

In 1967, just thirty years after the American Medical Association (AMA) testified against criminalization before Congress, the AMA’s position, expressed in an editorial in the Journal of the American Medical Association, was that “cannabis (marihuana) has no known use in medical practice in most countries of the world, including the United States.” (Emphasis added. One must ask: in what countries does it have medical use? And why would it be useful there and not in the United States?)

The AMA goes on to state, “The use of marihuana among Puerto Ricans and both southern and northern Negroes is reputed to be quite high. In all likelihood, marihuana use among the poverty-stricken urbanite is concomitant with other dependence-inducing substances and a broad range of asocial and antisocial activity.”

The AMA, and many of their members, had clearly bought the propaganda campaign, hook, line, and sinker. The piece closes with a rousing call to action: “Marihuana is centuries old, but it represents a constant danger. The responsibilities of the citizen, including the physician, are clearly defined. The time to begin is now.”

The AMA hasn’t really changed its position much in the subsequent fifty-seven years. For example, in 2022 they decided to support expungements of cannabis-related offenses, so they can appear to not be completely out of touch with the racial justice movement. Yet, they remain opposed to cannabis legalization, so there will continue to be more cannabis-related offenses (that need to be expunged). In 2023, they state, “cannabis for medicinal use should not be legalized through the state legislative, ballot initiative, or referendum process.”

This suggests that they are OK with the fact that more than 20 million Americans, mostly with Black and Brown skin, have been arrested since the War on Drugs began for nonviolent possession of cannabis. These arrests have caused a profound amount of damage to families, and have greatly harmed employment prospects, education, and housing opportunities.

(As you are reading this, you might not be surprised that only 15–18 percent of American doctors currently belong to the AMA, down from 75 percent in the 1950s.)

Why on earth did the doctors of the time go along with this obviously contrived propaganda campaign? How did they end up on the wrong side of the War on Drugs?