medical marijuana-an expedition from problem to policy

Running head: MEDICAL MARIJUANA- AN EXPEDITION FROM PROBLEM TO POLICY 1

Medical Marijuana- An Expedition from Problem to Policy

Luminus Afrin

Southeast Missouri State University

MEDICAL MARIJUANA-AN EXPEDITION FROM PROBLEM TO POLICY 2

Abstract

In 1972, the US Congress cited marijuana in Schedule I of the Controlled Substances Act

because they considered marijuana use product. Since then, 21 of 50 US states and DC have

legalized the medical use of marijuana. And in 1996b California became the fist ever state to

legalize marijuana for medical use.

Supporter of medical marijuana argue that it is medically effaceable for cancer, AIDS,

multiple sclerosis, pain, glaucoma, epilepsy, and other conditions. They cite dozens of peer-

reviewed studies, prominent medical organizations, major government reports, and the use of

marijuana as medicine for the sick people all over the world.

Opponent of medical marijuana argue that it is too dangerous to use, lacks FDA-

approval, and that various legal drugs make marijuana use unnecessary. They say marijuana is

addictive, leads to harder drug use, interferes with fertility, impairs driving ability, and injures

the lungs, immune system, and brain. According to the opponent party it could lead to

recreational use and become addiction.

Key words: public problem, public policy, marijuana, medical marijuana, stakeholder,

policy stream, policy analysis method.


Introduction

Medical marijuana is one of the tenacious issues now a day. The question is still

escalating about whether to legalize marijuana for medical purpose or not. Though is a kind of

drug but for many critically conditioned patients, marijuana is the only medicine that relieves

their pain and suffering without any side effects.

Over the years marijuana is become the most wanted medical product in the world. Here

in this particular paper for the course public policy analysis I will discuss how the problem made

its journey towards a policy but for the discussion we need to know the public problem about

medical marijuana, how does it become value conflict among parties, stakeholders map analysis,

king dons policy stream, and at last but not the least we will use the policy cycle model.

I think the triggering issue about medical marijuana is whether or not it should be

legalized. Other than that many stakeholder raised question about whether this is good for future

of the young people.

The initial part of this paper will identify the main public problem and the value conflict

concerning medical marijuana. Then the discussion turn towards stakeholder map analysis. The

third part will portray king dons policy stream from three point of views. The fourth portion will

discuss how it becomes a policy through policy cycle model. The final part will include

conclusion with recommendations. And major work will be cited with helpful appendix.


Discussion

Prior to major discussion of the paper we should have apparent idea about what

marijuana is and why it is considered medical marijuana, as marijuana is the basis of paper.

Basically Marijuana is a type of plant. According to www.drugs.com Marijuana is a green,

brown or gray mixture of dried, shredded leaves, stems, seeds and flowers of the hemp

plant Cannabis sativa. Marijuana is used as a psychoactive (i.e. mind altering) recreational drug,

for certain medical ailments and for religious and spiritual purposes. Sinsemilla, hash/hashish

(resinous form) and hash oil (sticky black liquid) are stronger forms of marijuana.

Marijuana is considered as medical use because it provides therapeutic benefit to the

patients of several diseases. Its also can be used as medicinal ways because it treat

chemotherapy patients who have nausea, vomiting and loss of appetite. Sometime its also helps

patients who are struggling with cancer and even AIDS. According to www.drugs.com mainly

there are eight types of medical use of marijuana. They are: Cancer, Glaucoma, HIV/AIDS ,

Muscle spasms, Seizures ,Severe pain, Severe nausea , Cachexia or dramatic weight loss and

muscle atrophy (wasting syndrome).

MEDICAL MARIJUANA - Public problem and value conflict

A proverb goes around the world that a problem turns out to be a policy. Each and every

policy is made from a popular public problem. Now we need to know what a public problem is.

Every policy analyst deals with this question. To have concrete thought what is or is not a

problem is an extremely vital job for a policy analyst. For this paper the public problem is to

whether marijuana should be legalized for medical use or not. There are several communities in a

society who are for and against the medical marijuana policy. As we can assume they conflict


views portray issues in a dualistic manner. This kind of situation creates value conflict. One

group of the citizens does not want marijuana to be medically legal because they think their

children will be affected and ultimately it will affect the social vale and norms. The other group

of citizen thinks to get rid of any sickness is most important. People should have proper medicine

to survive the disease. For that they dont care about what other group think. They just shore up

to legalize the marijuana medically.

Over the time conflicting values create policy problem. According to Anderson (85), a

policy problem is defined as a condition or situation that produces or dissatisfaction among

people and for which relief or redress by governmental action is sought. And in most of the

cases this kind of policy problem triggers to implement the policy for the related problem. And

for this paper there policy problem was the dissatisfaction of the citizens who never want the

marijuana to be medically legalized. And this is a good way to discover about the expedition of

problem to policy about medical marijuana.


MEDICAL MARIJUANA - Stakeholder analysis

Throughout the process from problem to policy several stakeholders becomes a part of

that process. When it comes to a question of policy to legalize marijuana there is lot of stake.

During that policy making process of legalizing medical marijuana many individual or groups

may gain or lose something. The stakeholders of legalizing medical marijuana are: citizens,

medical community, law enforcement, interest groups, and government. To better understand the

stakeholders situation and position we need to conduct the stakeholder analysis. According to

Mcbeth and Clemons (27), stakeholder analysis or mapping is in one sense recognition that the

policy process is political. It is recognition that there are actors whose cooperation, or at least

willingness no to obstruct is necessary for policy success. It is recognition that differences in

values, roles, perceptions and interest are probable.

Following is table for the stakeholder analysis which will help us to understand why

individual, organization or several group take interest in issues or programs to expedite the

problems to a popular public policy.


Table 1 stakeholder map

Stakeholders Stakeholders attitude Stakeholders power

Internal and/or

external

Cooperation(+)

/opposition (-)

Value

and

objective

Importance

H/M/L

Adoption

power

yes(y) no

(n)

Implementation

power yes(y)

no (n)

Who they

influence

Who

influence

them

Medical

Community

+ Social

value

H Y Y Community,

government

,citizens

Interest

group,

government

Interest group

-(Americans for

Safe Access

(ASA)

- California

Conference of

Local Health

Officers

(CCLHO)

- California

Narcotic

Officers'

Association

(CNOA)

- Social

and

economic

value

H Y N Citizens and

government

Government,

citizen

Citizens +/- Social

and

Economic

value

H Y N Every

stakeholder

Interest

group, the

media

Government - Social

and

economic

vale

H Y Y Every one citizens

Law

Enforcement

- Social

value

H Y Y medical

community,

government

Interest

group,

citizens

Though the stakeholder analysis take quite a bit of time and effort, its useful to have a

clear idea about the projected policy from the problem of whether marijuana should be legal or

not.


MEDICAL MARIJUANA- Kingdons policy stream model

Kingdons policy stream model is a great way to understand about how popular problems

like medical marijuana become a strong policy in some of the states. I will use these three

streams to analyze the journey of the problem to policy of medical marijuana.

Kingdon proposed three diverse streams of policy proposal. They are: the Problem

Stream, the Policy Stream, and the Politics Stream. When at any point at least two of the streams

cross, a policy window are opened for action.

The problem stream

Among the three streams The Problem Stream describes how different problems will take

place on the agenda of a decision-maker. This is done in a few different ways. Basically the

problems arise from a triggering event. And policy maker also get attention about a problem

from feedback from differs sources. When the public has something on its mind or an issue it

wants addressed, it will make decision-makers aware of their concerns through its feedback

(Kingdon 2003).

In this medical marijuana case the focusing event for the policy maker medical marijuana

is the California proposition 215. The stakeholders want this issue to be addressed. The

Californias Proposition 215 was the first statewide medical marijuana voter initiative adopted in

the USA. 56% voter support to male policy to legalize marijuana as medicine for only critical

conditioned patients. And I think this a great triggering event for medical marijuana.


The Policy Stream

The second stream is the policy stream. In this stream policies are made and interest

groups and other organizations and groups get along with government. Kingdon talked about

primeval soup, where policies basically originate. According to kingdom in this stream policy

maker check the technical feasibility, related cost, dominant social paradigm and the amount and

strength of political opposition they set in motion. Their main target was to make the proposition

215 clear of ambiguity, which could help the whole nation to implement the medical marijuana

policy.

Before originating the medical marijuana policy the decision maker need to take into

account the amount of possession of marijuana by any individual at a time. Some of the law

enforcement tried to be more liberal in case medical marijuana possession. But some other

stakeholders like the medical community and the interest groups they are opposed to the amount

of possession, they argued that the amount is too much indulgent. Some of the legislators

proposed to have ID card system for the patients. Id card is for to let the law enforcement know

who the original patients are. And all of these programs should work effectively and efficiently

because according to kingdom, it would be embarrassing to have some stupid fatal flaw

(kingdom 2003, 131)


The Politics Stream

The third and final stream is the politics stream. In this stream the problem gets noticed

and placed on agenda of the policy makers. To be more specific this is the stream where problem

becomes the policy by the decision makers. Here the problem is the triggering event discussed in

the problem stream. In this stream the political groups support policy proposition for the ultimate

gain.

Politics stream is the best way to know about the view point of the public about the issue

in hand. Because for any policy to be made and implemented public opinion is a very easy

approach to gauge. For this medical marijuana case, about 56% of the voters (public opinion)

voted to legalize marijuana under proposition 215. I think this was very strong pointer towards

the policy makers to place the issue on the policy making agenda. Though public opinion is

considered to be important sometime the perceptions are modified as consequence of election

results, perceived changes in the political ambiance, interest group activity. Kingdom considered

political factors as electoral, partisan, and pressure group factors (1995, 150-153)

And analyzing the streams I can say that the triggering event in the problem stream helps

out to get through the journey towards the implementation of policy. According to kingdon this

is considered as policy window, giving an issue to move the policy proposition forward.


MEDICAL MARIJUANA- Policy Cycle Model

The journey of legalizing medical marijuana can be better understood by breaking down

into the components that occurs within the political system. For this I am using the policy cycle

model formulated by Jones (1984), Dye (2008), Anderson (2006), and others. The policy cycle

model entails of four interrelated steps. The steps are as follows:

Figure 1 policy cycle model

In the first step an issue is identified as public problem. When the problem gets noticed

by the policy maker and can no longer be ignored, then the problem become the triggering event

to consider and placed in to the agenda. In case of legalizing marijuana as medical use the

triggering event was the proposition 215.

In this policy formulation stage, many available alternatives are being considered. Here

policy goals and means are analyzed. For the medical marijuana they were being searching for

Problem Identification / Gaining Agenda Status

Policy Formulation And Adoption (Including Funding)

Policy Implementation

Policy Evaluation/ Adjustment/ Termination


any other alternatives to legalize it. When public voted 56% for the medical marijuana, the

policy makers were considering several alternatives like ID card system, amount of possession,

licensing etc.

According to Mcbeth and Clemons (79), policy implementation refers to organizational

activities directed towards the carrying out of an adopted policy by administrative bureaucracies

at the national, state, and local level. After getting the public opinion from around 56 percent of

voters to legalize medical marijuana policy makers started to implement the policy. But there

were not enough funds to meet the policy objective. The interest groups opposed to implement

the policy.

The final step is the evaluation. Policy evaluation is needed to know about the outcome of

the policy. For the medical marijuana proposition 215 we have seen many supporters and

opposition. All of their advice takes into account in this step. Some of them want the policy to be

lenient and some of them tough.

Basically the policy cycle model is a continuous process. That is why continuous

feedback is inevitable. If one policy does not play properly, the decision makers try to fix it

through program justification.


Conclusion

The expedition from problem to policy of medical marijuana was pretty much nerve-

racking for all the stakeholders. Throughout the paper I discussed how the medical marijuana

becomes the triggering event for the policy makers and results as a popular policy in United

States.

I think the win-win policy for the entire stake holder would be to have strict marijuana

possession policy. Though the legislators suggested having ID card system and specified amount

of marijuana possession for medical use, I think this has flaws. And any program with flaws

cannot be a successful one. Because in this tech savvy world anyone can try to falsify the

information and can make fake ID.

By analyzing the problem to policy expedition my suggestion would be to introduce

electronic fingerprint and eye scanner system for the patients. The patients will have a database

for their fingerprint and eye scan. And every time they need marijuana they will have to come to

licensed store to get that. And the licensed store would be under strict monitoring system so that

that cannot sell marijuana for pleasure seeking people.


References

Americans for Safe Access. 2011 About Us. Americans for Safe Access.

California State Legislature. 2003. SB 420 The Medical Marijuana Program Act.

Hamilton, Shawn. 2009. To legalize or to not legalize: Should marijuana be legalized? Helium.

Kingdon, John. 2003. Agendas, Alternatives, and Public Policy. 2nd

ed. Addison-Wesley

Educational Publishers.

Newport, Frank. 2011. Record-High 50% of Americans Favor Legalizing Marijuana Use.

Gallup.

Vasconcellos, John, & Mark Leno. 2003. A Letter to All Parties Interested in Medical

Marijuana and SB 420. Safe Access Now.

Hoffman DE, Weber E. Medical Marijuana and the Law. 2010. New England Journal of

Medicine 362(16): 1453-1456.

Cohen P. Medical marijuana 2010: Its Time to Fix the Regulatory Vacuum. 2010. Journal of

Law, Medicine & Ethics 38(3): 654-666.

http://medicalmarijuana.procon.org/view.resource.php?resourceID=000881#summary

Annas GJ. Reefer MadnessThe Federal Response to Californias Medical-Marijuana Law.

1997. Legal Issues in Medicine 337(6): 435-439.

Mark Mcbeth, Randy Clemons. Public Policy Praxis. New York: Pearson, 2009.

Karen O'Keefe, State Medical Marijuana Implementation and Federal Policy, 16 J.

Health Care L. & Pol'y 39 (2013)


Legalization of Marijuana for Medical Treatment Amendment Act, Council of the District of

Columbia, Bill 18-622 (2010). Retrieved September 28, 2011 from

http://medicalmarijuana.procon.org/sourcefiles/DCMJLawMay2010.pdf

Delaware Medical Marijuana Act, Title 16, Del. Health and Safety Food and Drugs, Chapter 46A

(2011 May 13). Retrieved September 28, 2011 from

http://delcode.delaware.gov/title16/c049a/index.shtml


Appendix

medical marijuana-an expedition from problem to policy

Documents

medical use of marijuana

opponent of medical

introduction medical

supporter of medical

years marijuana

marijuana use product

medical product

medical purpose