After writing the original version of the text later published as Madmen Rule You, the subject matter crystallized further in my mind.

• Cannabis prohibition is a question of an evidentiary standard.

• The DEA rejects “anecdotal evidence,” i.e. reports by patients that they experience relief, as evidence that there is a medical use for cannabis.

• In other words, the patient’s subjective experience is meaningless.

• The DEA maintains that the patient’s testimony is irrelevant, because only it can see the truth.

I will explain.

After writing Madmen Rule You, I considered the DEA’s position that it will accept no evidence of a medical use for cannabis except the results of FDA-compliant Phase III clinical trials – not evidence that the states are permitting its use, not evidence that doctors recommend it for their patients, not evidence that there are doctors who believe it to be medicinal, not evidence that patients themselves say that it helps them – not even evidence that patients themselves say it helps them?

I thought about this position. I thought of a statement I saw quoted in the DEA’s ruling published July 8, 2011, denying the rescheduling petition of Americans for Safe Access (ASA). It blew my mind.

The DEA Ruling (Federal Register 40552, July 8, 2011) discusses the different evidence which ASA presented to prove that there is a “currently accepted medical use in treatment.” Of course, it rejects all the evidence. (Was there ever any question?) The DEA Ruling arrives at “Patients’ experience in which they reported benefits from smoking marijuana” on page 40580. The DEA Ruling cites to the ruling it issued when it denied the first rescheduling petition, brought by NORML in 1972.

I quote:

Anecdotal self-reported effects by patients are not adequate evidence of a drug’s accepted medical use. DEA previously ruled in its final order that –
Lay testimonials, impressions of physicians, isolated case studies, random clinical experience, reports so lacking in details they cannot be scientifically evaluated, and all other forms of anecdotal proof are entirely irrelevant.

DEA further explained in the same ruling why anecdotal reports by patients are irrelevant to the question of whether there is a medicinal use for cannabis. I quote the two more interesting of the four reasons which the DEA offered.

First, sick people are not objective scientific observers, especially when it comes to their own health….Third, any mind-altering drug can make a sick person think he feels better.

It really says that. The patient thinks he feels better, but he is wrong – he doesn’t really feel better. He only thinks he does. Who really knows whether the patient actually feels better? We know. How do we know? We know, because only we know the truth.

The DEA denies that the patient’s subjective sensory experience has any significance.
The patient’s testimony is not admissible – it is irrelevant.
In other words, there is no such thing as “self knowledge.”
In other words, you do not know yourself. Only the “expert” knows what you really feel, know, think.

Fundamentally, the DEA’s approach is to invalidate the testimony of physicians and patients as to their subjective experiences witnessing the patient’s condition in the context of the patient’s use of cannabis. That is the way to maintain cannabis prohibition: exclude the evidence.

A significant part of the task then is to change the standard of evidence which the federal government considers in deciding whether to let cannabis out of Schedule I so that it considers the testimony of patients, caregivers and physicians.