Pope Francis, the Golden Rule and Marijuana Policy Reform
By Miriam Boeri, PhD
On September 24, 2015, Pope Francis made history by being the first Pope to address a joint meeting of Congress. Frequent standing ovations often interrupted his talk, delivered in English, slowly and deliberately. One of the most moving turns in the Pope’s speech was his reference to the Golden Rule:
“We must not be taken aback by their numbers, but rather view them as persons, seeing their faces and listening to their stories, trying to respond as best we can to their situation. To respond in a way which is always humane, just and fraternal. We need to avoid a common temptation nowadays: to discard whatever proves troublesome. Let us remember the Golden Rule: ‘Do unto others as you would have them do unto you’ (Mt 7:12).”
Although addressing specific issues, his words were at once universal and personal. Capturing images we see in our minds, uncovering familiar but buried emotions, and stirring reflective thought, his words, like a poem by William Blake, gently urged us to “see a world in a grain of sand” from where we stand. [http://www.poetryloverspage.com/poets/blake/to_see_world.html]
While Pope Francis was referring to immigrants and refugees, his words apply to all who are disenfranchised by their situations and appeals to all of us to listen their stories.
As a sociologist who listens to the stories told to me by people who use drugs, I reflected on the possibility of bridging our differences of opinion to make medical marijuana available to the poor and disenfranchised who need it to relieve their suffering. After many years of political debate, marijuana prohibition is now being challenged by public outcry and popular vote. Yet those who oppose it say we need more research.
Research on the benefits of marijuana has been stifled in the US due to its status as a Schedule 1 drug. Yet a growing number of studies show marijuana’s medicinal purposes for a host of debilitating conditions (Aston et al. 2005; Bostwick 2012; Cabral et al. 2015; Campbell et al. 2001; Giacoppo et al. 2014; Grinspoon 2000; Lynch and Campbell 2011; Machado Rocha et al. 2008; Müller-Vahl 2003; Russo 2008; Schier et al. 2015; Schubart et al. 2014).
Recent epidemiology studies show that medical marijuana laws are associated with significantly lower state-level opioid overdose mortality rates (Bachhuber et al. 2014; Powell, 2015). Clinical studies show marijuana use does not harm recovering drug users and can even be beneficial Hill et al. 2013; Lucas 2012; Reiman 2009; Swartz 2010). These studies provide evidence supporting the stories I hear from many hard drug users that marijuana helps stop or reduce their use of other drugs.
One woman recalled how she stopped her heroin addiction by using marijuana while she was in a private treatment program years ago. “It got me off of heroin.” she said. “Cannabis stopped me from using every other drug.”
Another women told me how she weaned herself off methadone treatment by secretly using marijuana, which would have resulted in being kicked out of the methadone program if she had been caught.
A middle-aged man described how marijuana helped him to stop using heroin: “When you’re kicking heroin—it helps quell the nausea and it helps you be able to eat while you’re trying to get yourself well again.”
Marijuana is safer than many prescribed pharmaceutical drugs with negative side effects. For example, a young man told me he used marijuana to stop a twitching caused by a prescription medication he was given for a mental health condition: “A little marijuana helps to make the eye twitch go away so I can see well all day and keep my eyelids from twitching. Without it, it’s really impossible to control the twitching. At times it’s so bad I can’t even open my eyes.”
All of these people were using marijuana illegally and could be charged and convicted if caught. Although medical marijuana is legal in Massachusetts, it is very expensive to get a medical marijuana card to use it legally. Private insurance and public health programs do not cover medical marijuana.
Medical marijuana, under a physician’s care, can be a preventative solution to the opioid crisis. But since it was not recommended by the Governor’s Opioid Working Group as a strategy to combat the state’s opioid crisis, it cannot be legally used for treating addition.
The stories of the suffering show a different picture. One man who was addicted to opioids shared his views based on hard experience: “They’re giving them methadone. So all they’re doing is substituting; the cure’s worse than the cause. If you made marijuana available, people would already find something before they found something else that they liked. I think it’s a preventative—not a gateway--it’s a preventative measure.”
Contrary to fears that marijuana is a gateway drug, the people I spoke said the opposite. One man explained, “Eighty-five percent of the time I ever smoked crack, did cocaine, did pills or got drunk even, it’s because I didn’t have marijuana.”
All of these people were homeless or living in public housing. Some were in this situation because of a felony conviction for selling marijuana. One man now in his forties described his life after being in prison for selling six marijuana joints while in college:
“I have a felony record. I suffer from a lot of depression. You took a young man off the streets and you’ve ruined my life. What’s left for me? ‘Cause I’m never gonna be satisfied with the burger flippin’ job—I’m gonna tell you, part of me died. Part of me died from that day on when that happened.”
Their stories show how past offenses that resulted in a criminal justice record or unaddressed mental health conditions were the cause of their poverty. As poor people living in a state with public healthcare, they were often provided a variety of expensive prescription pills for free. Many of these pills were addictive, or had serious and debilitating side effects that marijuana helped relieve. Yet in a state where medical marijuana is legal, they cannot afford to use it legally.
Addiction and healthcare professionals in Massachusetts have been at the forefront integrating behavioral and medical care with policy. naloxone (Narcan), buprenorphine, and methadone have been the primary solutions to address the growing opiate addiction and overdose problem. Naloxone is an effective antidote, but not a cure or preventative therapy. Buprenorphine is a narcotic agonist and antagonist and used as a substitute for heroin. It has abuse potential and is addictive. Methadone, the most widely used substitute for opioids, is not only extremely addictive but it has a very narrow therapeutic index, which is the ratio between the toxic dose and the therapeutic dose of a drug. In contrast to the approved but addictive substitutes for opioids, marijuana has one of the widest (safest) therapeutic ratios of all drugs.
The recommendations and plan of action laid out in the Governor’s Opioid Working Group in Massachusetts claimed to include “bold new strategies.” [http://www.mass.gov/eohhs/gov/departments/dph/stop-addiction/recommendations-from-the-governors-opioid-addiction-working-group.html]
The report recommended more funding for naloxone, burprenorphine and methadone, which is needed but neither bold nor new. It did not include medical marijuana a strategy to help relieve the opioid crisis, which would be both bold and new. So while those with enough economic capital can access medical marijuana legally, it is not provided to the poor and disenfranchised.
Perhaps the words spoken by the Pope can change the hearts and minds of policymakers in the state with the highest percentage of Catholics. [http://www.thebostonpilot.com/article.asp?ID=14668]
Perhaps we can be moved if we “listen to their stories,” such as one told to me by a homeless young man who spent the last five years in and out of treatment homes and jail for opioid addiction and now uses marijuana illegally to help relieve his craving for opioids:
“I think that medical marijuana would be a great thing, especially in treatment. Obviously you have to try something else ‘cause not a lot of it worked so far, and I’ve seen a lot of death in my life.”
Perhaps we can build a bridge over our differences of opinion to “cooperate for the common good.”
In the words of Pope Francis:
“The challenges facing us today call for a renewal of that spirit of cooperation, which has accomplished so much good throughout the history of the United States. The complexity, the gravity and the urgency of these challenges demand that we pool our resources and talents, and resolve to support one another, with respect for our differences and our convictions of conscience.”