Over the course of my 52-year professional career as a forensic pathologist and medicolegal consultant, I have been involved in numerous civil and criminal lawsuits dealing with various kinds of drugs — prescription, over-the-counter and illicit. Some of these cases have been quite significant, including a few that have been the subject of congressional hearings.
Product liability and medical malpractice lawsuits involving drugs frequently result in multimillion-dollar verdicts. In other instances, the determination of which drugs may have led to someone’s death may provide the evidentiary basis for charging the provider with homicide.
Occasionally, some questions and doubts remain among medical practitioners as to the effectiveness of a particular drug and when it should be prescribed. However, almost all drug-related issues of this sort eventually get resolved. Some dangerous drugs have been removed from the marketplace, while others have been modified. Many times, pharmaceutical companies have been obliged to issue more definitive warnings about potential adverse drug reactions. There have been few long-lingering debates of a highly contentious, emotional nature.
There is one fascinating exception: marijuana.
Amazingly, the intellectual, medical, legal, societal and governmental debates about cannabis sativa continue with no definitive official resolution in sight.
What is the principal reason for the inability of our society to decide whether marijuana should become a legally prescribed drug?
The answer is Harry Anslinger.
Born in Altoona in 1892, Anslinger married a niece of Andrew W. Mellon, who, as secretary of the treasury, appointed Anslinger as the first commissioner of the Federal Bureau of Narcotics and started him off with a budget of $100,000 in 1930. Anslinger remained the head of the bureau for 32 years.
Harry Anslinger never became too concerned about heroin in those years because it was looked upon essentially as a problem limited to the African-American community and worthless drug addicts. What turned him on was the increasing use of marijuana among Caucasian high school and college students.
Anslinger undertook a propaganda campaign against marijuana that was even more intensive than the one directed at alcohol during the years of Prohibition. This campaign was mimicked in later years by Sen. Joseph McCarthy (a heroin addict and close friend of Anslinger’s) vis-a-vis allegations of communism.
I recall the movie “Reefer Madness” that Anslinger was largely responsible for, an incredible example of government-orchestrated propaganda that has been viewed on college campuses since the 1960s as a delightful parody.
The mythology of marijuana orchestrated by the vicious bias and intense zealotry of Anslinger became deeply embedded in the minds of Americans, and it has remained essentially unchallenged by mainstream society for more than 70 years.
Making it illegal
Marijuana, a compound derived from hemp that has been around for millennia and which was legal throughout most of American history, became illegal with the passage of the Marihuana Tax Act by Congress in 1937. For those who find it difficult to comprehend how their parents and grandparents could have been so misled, here are some quotes attributed to Anslinger that created the political background leading to the 1937 act.
• “There are 100,000 total marihuana smokers in the United States, and most are Negroes, Hispanics, Filipinos and entertainers. Their Satanic music, jazz and swing result from marihuana use. This marihuana causes white women to seek sexual relations with Negroes, entertainers and any others.”
• “… the primary reason to outlaw marihuana is its effect on the degenerate races.”
• “Marihuana is an addictive drug which produces in its users insanity, criminality and death.”
• “Reefer makes darkies think they’re as good as white men.”
• “Marihuana leads to pacifism and communist brainwashing.”
• “You smoke a joint and you’re likely to kill your brother.”
• “Marihuana is the most violence-causing drug in the history of mankind.”
As a direct result of the scientific nonsense foisted upon the American public by Anslinger and his supporters (including the powerful newspaper magnate William Randolph Hearst), marijuana came to be considered by most people as a potentially deadly narcotic.
Despite strong criticism in the “Joint Report on Narcotic Addiction” prepared by the American Medical Association and the American Bar Association, and completely ignoring the findings of an in-depth study by a special committee appointed by New York Mayor Fiorello La Guardia in 1939, which concluded that “the practice of smoking marihuana does not lead to addiction in the medical sense of the word,” Anslinger and his band of zealots and political opportunists succeeded in convincing the American public that marijuana was the most dangerous drug imaginable.
I recall that when I spoke about drug abuse to students and other groups during the years I was in the Allegheny County coroner’s office (1966-1980), I would point out that marijuana was not a narcotic insofar as universally accepted pharmacological-chemical categorization was concerned. Many teachers, parents and other adults were quite unhappy with my comments. They chose to believe that marijuana was the worst possible drug and that any suggestion to the contrary was unacceptable.
Updating the science
Over the past several years, a more objective, scientific evaluation of marijuana has been undertaken. While some medical professionals and scientists continue to express concern about marijuana, most reports have demonstrated that it is a mild hallucinogenic drug rather than a powerful analgesic. Marijuana is not an addictive drug that leads to physiological habituation and tolerance. Arguably, some individuals who use marijuana on a frequent basis may develop a psychological dependence. Such people are seeking an emotional crutch, and they may find marijuana to be safer, cheaper and more pleasurable than alcohol.
Colorado and Washington have now completely legalized marijuana and 18 other states have decriminalized it — even though marijuana use and possession is still illegal under federal law.
I have performed approximately 18,000 autopsies, and I have supervised or reviewed approximately 38,000 additional post-mortem reports since 1957. As a forensic pathologist performing autopsies on hundreds of people each year who die as a result of drug toxicity, I have never signed out a death due to cannabis, nor have I ever seen such an autopsy report from any other forensic pathologist.
Drugs known to cause death are legally available for numerous medical problems and are widely prescribed by physicians. Oxycodone, hydrocodone, vicodin and other opioids, as well as tranquilizers, sedatives, antidepressants and anxiolytic drugs, are prescribed in large amounts every day by thousands of physicians throughout the United States, even though it is well known that these drugs have produced an epidemic wreaking havoc throughout the country. There are now more deaths directly caused by these drugs each year in the United States than are caused by motor-vehicle accidents.
Numerous reports of sick individuals experiencing significant improvement from therapeutically administered marijuana have been documented. Patients suffering from late-stage cancer, neurological degenerative diseases, uncontrolled epilepsy and other serious, chronic, irreversible pathological processes have benefited greatly from the use of marijuana. It does not cure disease, but it can alleviate physical and emotional pain and suffering.
There simply is no rational reason, medical logic or justifiable legal basis for the refusal of the federal government and most states to decriminalize marijuana. It should be moved from a Schedule I category and allowed to be manufactured by pharmaceutical companies in the same controlled fashion that opioids and other dangerous drugs are handled commercially throughout the country.
Wasting lives, resources
Hundreds of thousands of people have been arrested and incarcerated for mere possession of marijuana. The amount of time, effort and money expended by law enforcement agencies, courts, and local and state governments responsible for the upkeep of prisons is immeasurable.
Law enforcement agencies should direct their attention to the distribution of illicit drugs — e.g., heroin, methamphetamine and cocaine — as well as the excessive, indiscriminate prescribing and dispensing of dangerous drugs by physicians and pharmacists who are indirectly responsible for thousands of deaths each year.
I do not believe marijuana should be made available on the open market, such as recently permitted in Colorado and Washington. People should not be allowed to simply walk into a store and buy marijuana-laced cookies or other forms of the drug as if they were pieces of candy. This likely would lead to greater dependence on marijuana by more people. But, while any kind of chemical dependence is neither physically healthy nor psychologically sound, the most egregious example of this in our society is the consumption of alcoholic beverages.
It is time for the mythology of marijuana to be exposed and set aside. A scientifically objective, societally reasonable and legally just approach should be adopted that would allow for the appropriate medical use of marijuana. A relatively mild drug that does not lead to death and which can alleviate physical and emotional pain and suffering deserves to be added to the therapeutic armamentarium of American medicine. Such a policy would be beneficial in many ways.
It is long overdue for the legacy of scientific ignorance, racial bigotry and political fanaticism that has seriously damaged so many lives to be exposed, dissected and buried. The bond between the long-deceased Harry Anslinger and modern-day society needs to be broken.
Cyril Wecht is a former Allegheny County coroner and medical examiner and a highly regarded consultant on medical-legal issues and forensic pathology.