Clearing the air: what the latest Supreme Court decision regarding medical marijuana really means.

handed down its 6-3 decision against Angel Raich and Diane Monson.1 The Court ruled that the federal government can prohibit even intrastate and noncommercial marijuana possession and cultivation under the rubric of “interstate commerce.” In the prior Supreme Court ruling, United States vs. the Oakland Cannabis Buyers’ Cooperative,2 the Court ruled that “medical necessity” is not a legal defense for the possession, manufacture, or distribution of marijuana, and that the federal law classifying marijuana as illegal has no exemption for ill patients. Although the latest decision did not address medical necessity or due process arguments, Justice Stevens, who wrote the majority opinion, did add at the end of Section I, “The case is made difficult by respondents’ strong arguments that they will suffer irreparable harm because, despite a congressional finding to the contrary, marijuana does have valid therapeutic purposes.”3 One week after the Supreme Court ruling, the US House of Representatives rejected an amendment prohibiting the federal government from undermining state medical marijuana laws. However, the bill received 13 more votes than last year, indicating growing support for patients. The Supreme Court ruling and the subsequent defeat in Congress brought much angst to many ill people currently using medical marijuana. Fortunately, for those living in states that allow the use of medical marijuana, this ruling does not overturn state law. Nearly all of the roughly 750,000 annual marijuana arrests in the United States are made by state and local officials. States are not required to have laws that are identical to federal law nor are they required to enforce federal laws. California Attorney General Bill Lockyer plainly stated this in a recent statement from his office: “The federal government cannot force state officials to enforce federal laws.”4 Although federal authorities retain the power to target patients and providers, state lawmakers should redouble their efforts to move forward with legislation to protect patients from arrest and jail. In addition, states without medical marijuana laws are still free to enact them. Following the