It started with a missing license plate lamp light on a California highway. The apprehending police officer approached the driver and could not mistake the odor coming from the car. He searched further and found hand-rolled cigarettes and nearly two pounds of marijuana. Sudi Pebbles Tripper said that it all belonged to her. She was charged with possession and transportation of marijuana.
At trial, Ms. Trippet sought to employ the common law medical necessity defense. The state objected to this defense and asked the court to preclude her from presenting it. In response, Ms. Trip-pet presented preliminary testimony from Dr. Tod Mikuriya, a psychiatrist and drug researcher. He testified that he prescribed Marinol, a prescription drug containing a synthetic marijuana compound, for Ms. Trippet's migraine headaches. He said that the federal Drug Enforcement Administration has acknowledged that Marinol is useful for any kind of condition that marijuana might be therapeutic for. But he acknowledged that marijuana was a relatively unknown treatment, and other forms of help were available for patients with migraines. The psychiatrist did not specifically testify that he approved the use of marijuana for Ms. Trippet.
The trial court excluded all evidence related to the defense of medical necessity, finding that the defendant had not established that she had no adequate alternative to using marijuana because Marinol was one such alternative.
She told the police office she smoked as much marijuana as she could, cooked with it, and did everything else that she could with it.
At trial, Ms. Trippet did not dispute the police officer's testimony that she told him she smoked as much marijuana as she could, cooked with it, and did everything else that she could with it.
The jury found her guilty of all charges. She appealed her conviction, arguing that, (1) the trial court improperly excluded the expert's psychiatrist's testimony, (2) she used marijuana for spiritual and meditative needs and the arrest violated her constitutional right to freely exercise her religion.
While the appeal was pending, California voters approved Proposition 215, The Compassionate Use Act of 1996. The purpose of the Act was to establish and protect the right of seriously ill Californians to obtain and use marijuana for a medical use that has been deemed appropriate and either recommended or approved by a physician. The broadly written law included any illness for which marijuana provides relief and both physicians and their patients would then be protected from criminal prosecution. On appeal, the defendant sought to apply Proposition 215 retroactively, arguing that it was a medical necessity for her to use marijuana and the transporting of marijuana was a necessity.
Holding: The Court approved the extension of the common law defense and held that Proposition 215 applied retroactively. It therefore ordered a limited retrial to determine whether a physician had approved or recommended the defendant's use of marijuana for medicinal purposes and what quantity of marijuana was reasonably related to her medical needs. The Court cautioned that, even with a physician's recommendation or approval, a patient may not possess an unlimited quantity of marijuana. Regarding the defendant's need to transport marijuana, the Court did not agree that the "transportation of two pounds of marijuana in a car by one who claims to suffer from migraine headaches is, even assuming the necessary medical approval, ipso facto permissible..." The test to be applied at the retrial was whether the quantity transported and the method, timing and distance of the transportation was reasonably related to the patient's current medical needs.
 | Michael Welner, M.D. Chairman The Forensic Panel |
Dr. Welner comments: Before marijuana was considered for medicinal purposes, the closest thing aficionados could find to its intoxicating features was benztropine. What of dronabinol (Marinol), the Schedule II drug with the active ingredient of 9-THC? And is there a future for the medicinal use of marijuana? Perhaps the answer shouldn't be so surprising.
Current accepted medical indications include the anorexia of chronic illness, and nausea and vomiting associated with chemotherapy. Researchers have found the combination of appetite stimulation, comfort, and anti-nausea to be intriguing. Initiatives are exploring applicability to anorexia nervosa and preliminary results of a pilot study funded by the pharmaceutical company Unimed have inspired a more extensive effort with Alzheimer's Disease. Investigators hope the drug, in addition to alleviating behavioral problems, will also counter the refusal of some Alzheimer's patients to eat. Unimed insists the benefit of Marinol are irrespective of intoxication or sedation.
Despite most aggressive research efforts to delineate an amotivational syndrome of marijuana, or other neurodegenerative effects, the research findings lag behind the hype. And dronabinol has not been associated with intellectual impairment. The more common effects on the emotions are elation and euphoria. Deep sadness is experienced by a small percentage of those who take it. So while I observe my civic and possibly medical duty to insist my pot smoking patients desist, I have less of a medical leg to stand on than I do with nicotine and alcohol, which is confirmed poison.
Behind the power struggle of the George Soros funded decriminalization forces and those whose pot-smoking spin doctors attempt to convince Americans we are winning the drug war should emerge a sincere research effort to determine the medical utility of THC related compounds. If so many of our patients use it as an antianxiety agent or as a sedative, can we refine the active ingredients to a legal compound with unique properties that emerges as yet another psychopharmacologic accidental success? Certainly, we wouldn't have compliance problems. This would be a more constructive end to a policy war that right now is fighting for the sake of fighting.
