October 24 – Dr. Gregory Carter was cross-examined by video today in Judge Kimberly J. Mueller’s federal courtroom in Sacramento, after Carter submitted a declaration in support of defendants’ claim in United States v. Pickard, et. al. that there is no rational basis to treat marijuana as a Schedule I controlled substance. Read more.
The government tried four times to vacate the matter. Judge Mueller said in court, “If the Supreme Court had not dropped footnote 37 in the Raich case, I might not deny the motion.” That footnote states: “We acknowledge that evidence proffered by respondents in this case regarding the effective medical uses for marijuana, if found credible after trial, would cast serious doubt on the accuracy of the findings that require marijuana to be listed in Schedule I….Respondents’ submission, if accepted, would place all homegrown medical substances beyond the reach of Congress’ regulatory jurisdiction.”
In a session that lasted over 2 1/2 hours, government attorney Gregory Broderick seemed to be stretching out his time with fairly meaningless questions and making Dr. Carter find numerous documents over and over, some of which were mis-numbered by the government attorneys, all the while trying to disparage him as an “activist.”
Broderick started with a list of questions about Carter’s background, which was quite impressive. After a BS and a masters in physiology, Carter earned an MD and did his residence, plus a one-year research fellowship at UC Davis. He is currently medical director at St. Luke Rehabilitation Institute in Spokane, WA. We found out he holds several board certifications, such as the American Board of Physical Medicine and Rehabilitation, the American Board of Psychiatry and Neurology, with a subspecialty in Neuromuscular Medicine. He is a fellow of the Association of Neuromuscular and Diagnostic Medicine, and the American Academy of Cannabinoid Medicine. Currently, he has a contract by the Washington Attorney General’s office to education physicians about cannabis.
Broderick wanted to know if Dr. Carter had recommended medical marijuana for his patients, and if so how often, and whether he issued warnings along with the recommendations. Broderick then asked, “Would you consider yourself a marijuana activist?” Carter answered, “No.” He was then asked, “Are you a member of NORML?” Carter responded that he was not, but added that he has worked with the group on some of their scientific pubs, and has respect for them. (Carter is a co-author with Cal NORML director Dale Gieringer of the Medical Marijuana Handbook. and wrote the foreword to NORML’s Emerging Clinical Applications For Cannabis & Cannabinoidsbooklet)
Broderick also asked whether or not Carter smoked marijuana himself. When defense attorney Zenia Gilg objected to the question, Broderick said it “goes to prejudice.” The judge overruled and Carter answered that he “went to college in California in the 70s” and smoked it then, but hadn’t in 25 years or more. He added, “If I had a disease like ALS (Lou Gehrig’s disease), I would.”
Instead of helping people out like good Dr. Carter (right), Broderick obviously had time (courtesy of our taxpayer dollars) to pore over Dr. Carter’s voluminous testimony and writings, and attempt to poke holes in them and prove him prejudiced. Broderick even dug up some broad statements made in a paper by Sunil Aggarwal, who was a doctoral student under Carter, and is now an MD and a fellow at the National Institutes of Health.
“Have you said that the US is at war with its own people over MJ policy?” was one question. Carter responded he had, because of the disconnect between what government regulations say and the day-to-day lives of patients, such as the ALS patients he said are the primary focus of his clinical interest.
“Did you say in 2008, you have an ethical duty to get involved in medical marijuana movement?” Broderick asked. “That sounds like something I would say,” Carter responded. “But you’re still not an activist?” “I think activists say things not based in science,” was the response.
Broderick then started hammering Carter about his statement that the AMA considers marijuana to have therapeutic benefit. He pointed out that the AMA’s language states marijuana “might” have therapeutic benefit, and said, “I’m just a lawyer but to me that means might.” Later when he was saying the same thing regarding scientific papers, the federally funded IOM report, etc., Carter was able to point out to that scientific experiments can never absolutely show causality, they can only establish a possible connection.
Then we got into adverse effects, with Broderick trotting out SAMHSA and DAWN data showing percentages of teens that enter drug treatment programs for marijuana, or mention marijuana use when they go to emergency rooms. Carter, who pointed out that he wasn’t an addiction specialist, didn’t mention that marijuana users are often forced into treatment by the courts, and that mentioning you’d used marijuana in an emergency room doesn’t mean that’s what sent you there.
Since he’d been contracted by the governor of Washington to write a request that the US Government re-schedule marijuana to Schedule II, Broderick asked Carter if he thought that Schedule II’s criteria, such as high potential for abuse, were correct. Gilg clarified that Carter was requested to ask for Schedule II by the governor. “Marijuana is safe under supervision of a doctor. If I’ve advocated for anything it’s exactly that,” Carter said.
Over some faulty footnoting regarding the Igor Grant study from the state-funded California Center for Medicinal Cannabis Research, and the Hazekamp meta analysis, Broderick tried to say that the Hazekamp paper only covered cannabinoids, not whole cannabis. Gilg on re-cross walked the doctor through the chart of 15-some studies that were analyzed in the paper, many of which used whole cannabis. At one point, Broderick read from the paper for one of his “might” statements, and Carter pointed out that the line following what he’d read had a different meaning. That line was: “Interestingly, trials involving pain patients with neuropathic-like features (e.g. multiple sclerosis, neuropathic pain and fibromyalgia) have produced mostly positive results, whereas studies measuring the efficacy of cannabinoids for acute pain (e.g. postoperative pain) have generated mostly negative results.”
Carter also pointed to Lynch et al (2012), a meta analysis of 18 placebo-controlled studies, 15 of which showed significant benefit, and all showed low adverse effects. “For neuropathic pain, there is overwhelming evidence that cannabis is effective,” said Carter. He read from Igor Grant’s paper, “Based on evidence currently available the Schedule I classification is not tenable; it is not accurate that cannabis has no medical value, or that information on safety is lacking.”
After trying to nail Carter on his papers calling for standardized dosages of cannabis, Broderick then asked the truly scientifically illiterate question, “Why call for clinical trials if you’re convinced it works?” ‘I’m still a scientist at heart and I like evidence,” Carter replied. “I’m always in favor of more research.” He pointed out that he has been trying to get a NIDA grant to study ALS in humans, building on animal studies. He said he gets 20-30 emails monthly asking why he is not doing clinical trials on cannabis for ALS.
Six co-defendants in orange jumpsuits were in the courtroom; it was said they have served three years and that the government wants 10-15 years for all, in a conspiracy they have tied to 1,884 plants grown in Shasta-Trinity National Forest, combined with plants being grown at Brian Pickart and Bryan Schweders’ properties. Another defendant reportedly operated a hospice in Los Angeles.
The show continues on Monday starting at 9 AM, with defense witnesses Dr. Carl Hart and Phillip Denny, MD, and government witness Bertha Madras, PhD.
(Thanks to Paul Armentano of national NORML for filling in details. See Paul’s background on the case.)
Also see: Marijuana ban to have rare hearing in federal court Bob Egelko, SF Chronicle
War on marijuana unconstitutional, doctors testify in federal court Monday David Downs, Smell the Truth
Should the Feds reclassify marijuana? US judge holds hearing Christian Science Monitor
Why Today is a Historic Day for Cannabis Policy Jeremy Daw, The Leaf Online