Anticipating the end of a tired and painful stigma
AFTER THREE YEARS AT SEA, Captain Thomas Kemble returned home and kissed his wife. Unfortunately for him it was 1656, the door was open, and it was Sunday. Consequently, the formerly upstanding member of his Puritan community soon found himself locked in the stocks, charged with both “lewd and unseemly behavior” and with violating the Sabbath, crimes for which he was publicly humiliated for two hours.
Public kisses are now commonplace, of course, as are alcohol sales, sex outside of marriage and working on Sunday. All of those are legal as well, despite having been illegal at various points in U.S. history. As importantly, they’re all widely accepted behaviors. Times change, attitudes change and laws change—but not always in that order. If public opinion can help to shape the law, so can the law occasionally help to shape public opinion, and in the case of cannabis this holds promise.
As of this writing, 29 states along with the District of Columbia, Guam and Puerto Rico allow for public medical cannabis programs, and nine of those also have legalized cannabis for recreational use, further shortening the distance to national acceptance. The impacts of this could be profound, even merciful, and that’s no exaggeration.
Prohibition laws grounded in morality (as opposed to in a genuine concern for safety) satisfy the personal convictions of some portion of a population, but such laws are not always concerned with the welfare or broader ethics of the greater society. In addition to their problematic subjective origins, these laws can carry two penalties: the prescribed legal punishment and the additional consequence of stigma, i.e. shame. Breaking such a law makes one not just a criminal, then, but also an immoral person, and it’s that last bit—the stigma—that’s been an obstacle to patients seeking relief from pain.
A 2015 study published by the Journal of Psychoactive Drugs and made available by the U.S. Library of Medicine and the National Institutes of Health found that “The stigmatization of medical marijuana … has a profound effect on how patients seek treatment, and whether they seek medical marijuana treatment at all… Stigma emerged as a primary and recurring issue as it related to both the process of becoming a medical marijuana user, and remaining one.”
The study’s subjects, all living in the San Francisco Bay Area, in some cases waited years before investigating medical cannabis as a possible treatment to help with their conditions. One cancer patient didn’t enquire about it until her second or third round of chemotherapy, and then only because a nurse suggested it as a way to assist with the patient’s sickness and loss of appetite. Many of those interviewed voiced concerns about what family members or associates might think of them, with some telling only their spouse or immediate loved ones and not mentioning their treatment even to close friends lest they be branded a “stoner” or a “pothead.”
“There was obviously that kind of negative stigma of using marijuana that I'd be looked upon as kind of an addict or a drug user more than a patient,” one said.
“I won’t broadcast it,” said another. “I’ve had close friends who would make derogatory remarks about people who smoked and they didn’t know I smoked.”
Others in the study held fears of being negatively regarded in the workplace or even fired, while a few felt that cannabis, even medically prescribed, was somehow illegitimate.
“At the beginning I would say, ‘Okay, this medical marijuana might be a little bit kind of shady,” one said. “I was thinking it was going to be some shady doctor that's willing to just write you a prescription if you paid the right amount of money, that was kind of the fly-by-night operation kind of thing, something very shady and underhanded.”
In my mother’s case religion played a significant role, not just in her refusal to consider medical marijuana to help with her cancer treatment, but in her initially foregoing chemotherapy altogether. Raised in a conservative Midwestern family, her conversations with members of her Assembly of God (AG) church in North Carolina, to which my parents had retired, led her to decide to follow a course of prayer and limited pain management rather than go “all in” with chemotherapy, which her oncologist was advocating strongly. It should be mentioned that while the Assemblies of God believe in divine healing, they do not see modern medicine as incompatible with that, and as a matter of official policy they support medical treatment and doctors.
Still, evangelical pastors regularly frame marijuana use as a moral issue, as shown at a 2014 public hearing on marijuana availability in Cañon City, Colorado, where the local Daily Record paper quoted AG Pastor Larry Kettle, who was at the hearing to speak against marijuana, as saying: “I think that once a moral boundary begins to slide, then more and more moral boundaries will slide afterwards…People may say to us, 'where were you when we legalized medical marijuana?,' but I will tell you at this point in time, I want to stand up for moral values and that's why I am here.”
Faith aside, fear was a large part of my mother’s reluctance to undergo chemo, including the fear of pain, nausea, losing her hair and the other well-known effects of the treatment. She said as much, and when I offered that there were ways to address some of those effects and mentioned medical cannabis, her response revealed another fear, that of stigma. Cannabis in any form was inconceivable to her, in terms of the law, in terms of how she’d be regarded by her community, and in terms of how she’d see herself, and so a possible tool for her treatment was eliminated from consideration.
In contrast, my mother-in-law was raised in California, fondly remembers seeing The Doors performing on the Sunset Strip when she was a teenager, and she’s spent her adult years in the company of artists, actors, directors and creative types. When she received her breast cancer diagnosis, not long after my mother had received hers, her response was immediate: whatever it takes. She began chemotherapy right away—and yet she, too, didn’t consider medical marijuana use during treatment. Despite being in an accepting environment with plenty of information about and access to medical cannabis, she says it was never suggested to her as a possibility.
“That was 2006, and if you had mentioned it everybody would have looked at you like you were crazy,” she says. “Because they have all the drugs and then they have the drugs to deal with the symptoms. They give you the [chemotherapy drug] Taxotere, then they give you something to control the Taxotere. Marijuana wasn’t in the loop.”
Today she says she’d have tried it if her doctor had suggested it, though my wife is doubtful based on what she says were her mother’s past views on marijuana. Whatever the case, my mother-in-law says that legalization has changed her perspective on cannabis, in part due to the current proliferation of information dispelling myths that she and others have long held.
“It took a lot of people a long time to tell people that everything that is marijuana is not hallucinogenic—that you’re not going to freak out,” she says. “And there’s so many alternative treatments that do nothing, but this one really seems to work."
By the time my mother decided to fight her cancer medically, many years after her diagnosis, it was too late. Given her faith I’m not sure that even full legalization of cannabis, medical and recreational, would have had any impact on her treatment decisions, but the scenario might be different for others and it’s heartening to see things changing. After all, by definition, to legitimize something means to make it legal, and so with legalization cannabis is now legitimate to many who might have been skeptical in the past. Of course legalization won’t spell the complete end of the stigma around cannabis use, but it is evidence that the stigma is in decline. Even Prohibition still has its supporters, with the longstanding Prohibition Party (founded in 1869) still teetotaling along and planning to field a presidential candidate in 2020. But its proudest achievement, the 18th Amendment, is long gone, the party’s 2016 presidential candidate only received 5,617 votes and the numerous beers enjoyed at so many public events are evidence enough that Prohibition’s supporters are no longer relevant. Likewise, today’s public displays of affection—including those among same-sex couples—can go far beyond kissing and would probably stop a Colonial Puritan’s heart, but the Puritans’ way of thinking long ago ceased making sense.
To their modern ilk or to those who continue to judge cannabis users I would offer that there is no shame is seeking healing or an escape from pain or even a bit of relaxation with friends. Rather, the disgrace is to hold as immoral an instrument of healing that predates even the notion of morality. At some point a couple decided to leave the door open when they kissed and society decided it wasn’t a big deal. In the case of cannabis there’s a lot of pain and fear behind doors, still closed in 21 states. Here’s to getting them opened soon.
By Reade Tilley, Editorial Director.