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Is the Access to Medical Marijuana a Fundamental Right?

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We write blog posts about cannabis, but most of the time the posts are about things that are happening in the cannabis world. This post is about whether something should happen in the cannabis world. Specifically, should American courts recognize the access to marijuana as a fundamental right for all Americans? This is not intended to be a partisan piece; rather, one that examines marijuana in the context of existing Constitutional jurisprudence as recognized by United States Supreme Court precedent.

Let’s be very clear: You can read the Constitution from start to finish, and you will not find any provision that expressly enumerates the right to access marijuana. So, if the right is to exist, it must be one of a limited number of unenumerated fundamental rights that have been recognized by courts.

What Is a Fundamental Right?

Unenumerated fundamental rights are, essentially, a creation of the courts arising from the due process clause of the 14th Amendment to the Constitution, which reads in relevant part: “No State shall…deprive any person of life, liberty, or property, without due process of law.”

The Supreme Court has defined a fundamental right as a right that is “deeply rooted in this Nation’s history and tradition and implicit in the concept of ordered liberty.”

Examples of fundamental rights recognized by the Supreme Court include:

  • The right to marriage;
  • The right to public education;
  • The right to interstate and intrastate travel; and
  • The right to privacy.

Does Marijuana Meet the Definition of a Fundamental Right?

Let’s get this out of the way: Adult-use marijuana is almost certainly not soon – if ever – to be recognized as an unenumerated fundamental right. While it is conceivable that a Constitutional amendment would provide that right, the right is not one that lends itself neatly to being recognized as fundamental by the judiciary.

But when it comes to marijuana used for medicinal purposes, the analysis – even if not the result – should be different. After all, the right to access medicine, and use that medicine to treat diseases, is inherently different from the right to experience a certain type of feeling simply for recreational purposes.

Framing the Issue

The difference between the medicinal and recreational uses of marijuana perhaps brings us to one of the first critical questions in determining whether the right to use marijuana for medical purposes is protected by the Constitution: How do you phrase the question presented to a court about the scope of the right?

Oftentimes in fundamental rights cases, the answer to whether a right is fundamental is determined by how the right is phrased. The Supreme Court has said as much: “[W]e have a tradition of carefully formulating the interest at stake in substantive due process cases.”

By way of example, the Supreme Court has recognized a fundamental right to refuse life-saving medical treatment recommended by a physician (i.e., “the liberty of competent, terminally ill adults to make end of life decisions free of undue government interference”), but in the same opinion, declined to recognize a right for that same physician to assist in ending the patient’s life. While these are tough questions, reasonable people can disagree as to whether this is a distinction without a difference.

As another example, in 1967 the U.S. Supreme Court was tasked with reviewing the constitutionality of Virginia’s Racial Integrity Act in Loving v. Virginia, which made interracial marriage a felony. The Court struck down the law, reasoning that “[m]arriage is one of the basic civil rights of man. Fundamental to our very existence and survival.” Surely there is little doubt that, right or wrong, had the question been presented to the Supreme Court in 1967 whether there was a right to same-sex marriage (and not marriage generally), the Court would have reached a different conclusion. After all, it was a different time with different popular beliefs. We can’t overlook the fact that it took the Court another 48 years to extend Loving’s marriage protections to same-sex relationships. In 2015, the Court did finally recognize that right in its Obergefell v. Hodges decision.

As a final example, the Court’s decision in Roe vs. Wade recognizing the fundamental right to an abortion under certain circumstances (which, of course, was overturned in 2022 by Dobbs v. Jackson Women’s Health Organization) was the result of a series of cases where the Court had recognized a right to privacy. Just as in the case of interracial marriages, I suspect the Court that originally recognized a general right to privacy may not have been willing at that time to extend that right to the right to an abortion under certain circumstances.

Viewed under the lens of these examples, it seems important to present to the Court a purported fundamental right that the Court is prepared to recognize. Said another way: Phrasing is everything.

Supreme Court Cases Examining Marijuana

The issue of access to medical marijuana has come before the Court on at least two occasions, one directly and one indirectly.

First, in the 2001 case U.S. v. Oakland Cannabis Buyers’ Cooperative, the Court addressed whether there was a medical necessity exception to the Controlled Substances Act’s prohibitions on manufacturing and distributing marijuana. While the Court did not address the fundamental rights issue directly, it suggested that it would be futile to press a claim of constitutional right to access marijuana as a form of medical treatment. In so doing, the Court assumed a highly deferential stance toward congressional fact finding:

Only [then-]Justice Stevens, who concurred in the judgment, obliquely noted that the question whether the medical necessity defense “might be available to a seriously ill patient for whom there is no alternative means of avoiding starvation or extraordinary suffering”—that is, whether the defense might be recognized if a patient rather than a distributor had raised it—“is a difficult issue that is not presented here.”

Then in the 2005 case Gonzalez v. Raich, which is widely known as a case examining the extent of Congress’s Commerce Clause powers, the Court held that Congress’s power to regulate interstate commerce authorized it “to prohibit the local cultivation and use of marijuana.”

The Court rationalized that Congress had “enacted comprehensive legislation to regulate the interstate market in a fungible commodity” and that “exemption[s]” for local use could undermine this “comprehensive” regime. The Court stressed that Congress had decided “to prohibit entirely the possession or use of [marijuana]” and had “designate[d] marijuana as contraband for any purpose.” Prohibiting any intrastate use was thus, according to the Court, “‘necessary and proper’” to avoid a “gaping hole” in Congress’s “closed regulatory system.”

At the time Raich was decided, maybe that was true, maybe not. But no reasonable person can dispute that federal marijuana policy has changed since 2005.

A Pathway to Recognition of a Fundamental Right

This is a point we’ve made before in a different context:

Ironically the Ninth Circuit’s 2007 opinion on remand after the Raich decision – even though it ultimately concluded that there was no fundamental right to the use of marijuana for medical purposes – provides a straightforward and remarkably prescient roadmap for the current liberal Justices to conclude that such a right does now exist.

On the question of whether marijuana is “deeply rooted in this Nation’s history,” the Ninth Circuit noted that:

It is beyond dispute that marijuana has a long history of use — medically and otherwise — in this country. Marijuana was not regulated under federal law until Congress passed the Marihuana Tax Act of 1937, and marijuana was not prohibited under federal law until Congress passed the Controlled Substances Act in 1970. There is considerable evidence that efforts to regulate marijuana use in the early-twentieth century targeted recreational use but permitted medical use. By 1965, although possession of marijuana was a crime in all fifty states, almost all states had created exceptions for persons for whom the drug had been prescribed or to whom it had been given by an authorized medical person.

On the question of whether a right that may not have been recognized as fundamental in the past may nonetheless be recognized as a fundamental right, the Court used Lawrence v. Texas as an example:

The Lawrence Court noted that, when the Court had decided Bowers v. Hardwick, twenty-four States and the District of Columbia had sodomy laws. By the time a similar challenge to sodomy laws arose in Lawrence in 2004, only thirteen states had maintained their sodomy laws, and there was a noted “pattern of nonenforcement.” The Court observed that “times can blind us to certain truths and later generations can see that laws once thought necessary and proper in fact serve only to oppress.”

On the other hand, the Ninth Circuit was troubled by the fact that medical marijuana had not yet been adopted by a sufficient number of states:

Though the Lawrence framework might certainly apply to the instant case, the use of medical marijuana has not obtained the degree of recognition today that private sexual conduct had obtained by 2004 in Lawrence. Since 1996, ten states other than California have passed laws decriminalizing in varying degrees the use, possession, manufacture, and distribution of marijuana for the seriously ill.

But the court noted that it may have reached a different conclusion if medical marijuana had been permitted in more states and more popularly accepted:

We agree with Raich that medical and conventional wisdom that recognizes the use of marijuana for medical purposes is gaining traction in the law as well. But that legal recognition has not yet reached the point where a conclusion can be drawn that the right to use medical marijuana is “fundamental” and “implicit in the concept of ordered liberty.” For the time being, this issue remains in “the arena of public debate and legislative action.”

For now, federal law is blind to the wisdom of a future day when the right to use medical marijuana to alleviate excruciating pain may be deemed fundamental. Although that day has not yet dawned, considering that during the last ten years eleven states have legalized the use of medical marijuana, that day may be upon us sooner than expected. Until that day arrives, federal law does not recognize a fundamental right to use medical marijuana prescribed by a licensed physician to alleviate excruciating pain and human suffering.

Whether you agree with the analysis of the Ninth Circuit, it would border on intellectual dishonesty to argue that the concerns of the Ninth Circuit in 2007 have – rightly or not – been allayed at this point. Just two years ago, Justice Thomas laid out all of the ways that marijuana is no longer the subject of a comprehensive nationwide prohibition and the various mixed signals sent by the federal government in recent years:

  • In 2009 and 2013, the Department of Justice issued memoranda outlining a policy against intruding on state legalization schemes or prosecuting certain individuals who comply with state law.
  • In 2009, Congress enabled the District of Columbia’s government to decriminalize medical marijuana under a local ordinance.
  • In every fiscal year since 2015, Congress has prohibited the Department of Justice from “spending funds to prevent states’ implementation of their own medical marijuana laws.”
  • Nearly 40 states allow medicinal marijuana use, and approximately 22 of those states (and D.C.) also allow recreational use.

Put another way, everything that the Ninth Circuit stated had not yet occurred in 2007 has in fact occurred by 2023. It is extremely difficult to imagine that the same court would reach the same conclusion now.

Could Congress or States Still Regulate Marijuana if It Is Recognized as a Fundamental Right?

Of course! When abortion was recognized as a fundamental right, abortion restrictions were upheld provided that the restrictions did not impose an undue burden on that right. Even express rights in the Constitution can be regulated – after all, you cannot yell “fire” in a crowded movie theater. If the Court recognizes access to marijuana for medical purposes as a fundamental right, Congress could still regulate the time, place, and manner in which that right was exercised. For example, a state surely could prohibit smoking marijuana in schools, even if for medical purposes. Or prohibit driving while impaired even if the impairment was caused by the use of marijuana for medical purposes.

Should the right to access marijuana for medical purposes be recognized as fundamental by the United States Supreme Court? It’s a close call, and certainly would engender some controversy for the Court just as virtually every other newly recognized fundamental right has. But we suspect (and repeated polls confirm) one that if recognized would be largely greeted with acceptance by a large portion of Americans.

Perhaps we should look to cartoonist Gilbert Shelton, who may have summed up the issue more succinctly than even the more erudite justices could: “Weed will get you through times of no money better than money will get you through times of no weed.” How much more fundamental can you get?



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Minnesota Office of Cannabis Management Issues Rejections to Majority of Social Equity Applicants

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The Minnesota Office of Cannabis Management (“OCM”) has begun issuing final denials to the overwhelming majority of previously qualified social equity applicants (“SEA”s) ahead of its first statewide cannabis lottery on December 2 for 280 available “preapproval” cannabis licenses.

Flag of Minnesota in Marijuana leaf shape. The concept of legalization Cannabis in Minnesota. Medical cannabis illustration.

Per reporting from MJ Biz Daily, “The applicants who are barred from the lottery failed to complete the application process or acted improperly by submitting multiple applications or disguising the true investors in their companies, according to [OCM].” Obviously applying for more licenses than is allowed and/or concealing owners or financial interests are clear grounds for SEA application rejection. Other alleged “deficiencies” though may not be so cut and dry.

While state law does not permit appeals from denied applicants (which is not uncommon for states with cannabis licensing programs), impacted SEAs can still secure a review of their records submitted to the OCM within seven days of the rejection decision (by logging into their Accela Citizen Portal and pulling the internal record there).

The main issue emerging as a result of these rejections is the fact that the OCM did not consistently issue deficiency notices to rejected applicants if there was a material problem with their submitted applications (although as of October 16, the OCM had sent out deficiency notices to over 300 SEAs). In turn, there are instances here where SEAs were rejected for minor, seemingly non-material deficiencies in their applications (things like submitting incorrect corporate documentation that still contained the same information the OCM sought, or re-submitting documents upon request by the OCM only to be rejected for lack of the same document after-the-fact, or even blank denials altogether with no stated reason for rejection).

In an interview with the Brainerd Dispatch, Charlene Briner, the interim director of the OCM, cast these denied SEA applications into four categories:

  • Failure to meet the basic qualifying standards under state law (i.e., social equity applicant owning at least 65% of the business among others)
  • Failure to provide the requisite verification documents (i.e., legitimate business plans, source of funds, ID, etc.)
  • Hidden or inconsistent ownership or true parties of interest
  • Fraudsters (i.e., those trying to game the system by flooding it with multiple applications via proxy or otherwise by using the same address or phone number tied to the same person on multiple applications)

The first and second bullet points above are going to be the ripest ground for rejected SEAs to try to stop the OCM prior to the December 2 lottery, but that’s only if those rejected SEAs can very quickly obtain copies of their submitted documents (within 7 days of the rejection) and start the administrative litigation process and/or seek injunctive relief at the same time against the OCM.

What was once more than 1800 qualified social equity applicants for the lottery has been winnowed down to around 640. The OCM rejected applicants for a multitude of reasons, some of which are clearly legitimate and some of which appear to be questionably enforceable from the perspective of complying with Minnesota’s state constitution and its administrative procedure act.

If you’ve been impacted by an OCM rejection, you do not have much time to act ahead of the December 2 lottery. If you have questions about your potential civil or administrative claims against OCM due to a questionable SEA rejection, contact Jeffrey O’BrienHilary Bricken, or Nick Morgan.

Minnesota Office of Cannabis Management Issues Rejections to Majority of Social Equity Applicants



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Wait? My CBD Business May Be Racketeering? A Potential Existential Crisis We Have Been Warning About

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Even the most responsible hemp operator should understand that it operates in a world full of risk. But I doubt many of them believe they might be accused of racketeering. Last week, the U.S. Supreme Court heard arguments about whether to sanction a commercial trucker’s attempt to bring a racketeering claim against CBD companies, whose allegedly mislabeled products the trucker claims led to his firing.

As always, Sam Reisman at Law360 distills the issue nicely:

The case concerns an allegation that companies sold CBD products with detectable amounts of THC, purportedly costing plaintiff Douglas J. Horn his job as a commercial trucker after he tested positive on a drug test. Oral arguments on Tuesday hinged largely on whether Horn’s claims stemmed from a personal injury — which would be excluded from the Racketeer Influenced and Corrupt Organizations Act, or RICO — or whether his firing was an economic injury and therefore redressable under RICO.

In taking the case, the U.S. Supreme Court could resolve a 3-2 circuit split over whether the civil prongs of the RICO statute allow a plaintiff to seek damages for economic harms stemming from injuries to their person.

Again, from Reisman:

During oral arguments on Tuesday, the liberal wing of the high court expressed skepticism with the CBD companies’ rendering of the case, which they said foregrounded Horn’s ingestion of the product as the source of the injury, as opposed to his firing for a positive drug test.

Lisa Blatt, an attorney for the CBD companies, told the justices that agreeing with Horn’s interpretation of the statute would open the door for virtually limitless personal injury cases under civil RICO, as long as plaintiffs could allege some connection between their ingestion of a product and a loss to their business or property: “Respondent’s rule also leaves the personal exclusion [in civil RICO] toothless, since virtually all personal injuries result in monetary loss,” Blatt said. “It is utterly implausible that Congress federalized every slip-and-fall involving RICO predicates. Personal injuries are serious and may support state tort claims, but they are not the stuff of RICO.”

On the other side, conservative justices attempted to discern how to draw a line between bona fide economic claims and personal injury claims pleaded as economic claims.

Easha Anand, arguing on behalf of Horn, said the vast majority of personal injury claims, such as those alleging pain and suffering or emotional distress, would still be excluded even if Horn was permitted to pursue his RICO claim against the CBD companies: “In your average slip-and-fall case, you’re not going to be able to prove a predicate act, let alone a pattern of predicate acts, let alone a pattern carried on through a racketeering enterprise,” Anand said.

Justice Neil Gorsuch observed, “There’s a failure to warn that this product contains ingredients that your client didn’t know about and should have known about and had a right to know about. I would have thought that that would have been kind of a classic personal injury.”

The Takeaway

This is pretty scary stuff for CBD and other hemp operators. RICO is no joke and carries very serious penalties (both civil and criminal depending on who is bringing the suit).

From the perspective of a CBD manufacturer, it seems unfair to hold the manufacturer responsible to control how its products are used and, as in this case, the implications of that use (here, an alleged economic injury).

If the Court rules that CBD and other hemp manufacturers are subject to RICO charges simply by selling their products to people who do things outside of the manufacturers’ control, it could pose an existential crisis to the industry with potentially unlimited civil (and maybe even criminal) liability. We have warned about this before.

That said, while it’s always difficult to predict how the Supreme Court will vote on any issue, I do not believe the Court will push the hemp industry to the brink. I suspect the Court will either rule that the claims in the present case are personal injury claims excluded from RICO and/or provide guidance for how lower courts should examine such “mixed” claims.

We’ll of course provide additional information once we hear from the Court. Stay tuned.



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What ‘material’ about therapeutic goods is considered advertising?

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It is important to note that advertising health services is subject to different regulations than advertising therapeutic products. Consequently, advertisers, manufacturers and sponsors must evaluate whether their business name could be interpreted as an advertisement for therapeutic goods. If so, they should consider whether the business name, including company or trading names, could be viewed as a ‘reference’ that draws the audience’s attention to medicinal cannabis, as any mention or similar terms to ‘cannabis’ are likely to have that effect. It is essential to recognise that the impact of promoting the use or supply of medicinal cannabis does not depend on a single promotional element but rather on the overall promotion. This includes all components of the promotional information and materials that accompany the name or branding. Advertising can result from the combination of separate statements, images or designs that collectively promote the use or supply of therapeutic goods.

Advertising

The prohibition on advertising medicinal cannabis to the public is determined by the context in which the material is perceived. When evaluating whether information about therapeutic goods qualifies as advertising, it is essential to consider the broader context of the material’s presentation. This encompasses various factors that influence the conveyed message, including the context of the information or activity, the intended audience and their likely interpretation of the message, as well as the presence of non-verbal and unwritten cues, such as visual elements. These factors can significantly affect communication and may alter the message perceived by consumers. 

For example, if an advertisement for a health service, such as a pain treatment service, includes references to medicinal cannabis, even in the company name or trading name, a reasonable consumer may conclude that the advertisement seeks to promote both the use of medicinal cannabis for pain relief and the pain treatment service itself. Including a disclaimer, such as advising the consumer to consult a health professional regarding suitable treatment options, does not exempt the advertiser from complying with legislative requirements.

The distinction between promoting a health service and the therapeutic product utilised in its delivery can be nuanced. Therefore, it is crucial for advertisers to consider how a typical consumer might perceive their advertisement in relation to the promotion of the therapeutic product.

Legal Compliance

To ensure legal compliance in promoting a business or service, advertisers should focus on the health services they provide and avoid referencing medicinal cannabis. For instance, stating “Our clinic offers consultations related to pain management” is a more compliant approach. The Therapeutic Goods Administration’s interpretation of advertising for medicinal cannabis is broad, covering all methods of promoting its use or supply. This includes company names, product names, abbreviations such as CBD and THC, colloquial terms, and any imagery related to cannabis. Any combination of statements or images that implies medicinal cannabis can be considered advertising, even in the absence of explicit promotional language.

Summary

In summary, it is prohibited to mention prescription medications in advertisements for therapeutic goods. If content discusses health conditions and consumers can reasonably infer, either from the context or through direct or indirect references, that medicinal cannabis or any other prescription medication is intended for use concerning these conditions, the content may be deemed an unlawful advertisement for therapeutic goods. Not all information related to therapeutic goods is classified as advertising. However, if the content aligns with the definition of ‘advertise’ as outlined in the Therapeutic Goods Act 1989 (Cth)—which includes anything that is directly or indirectly intended to promote the use or supply of therapeutic goods—then the relevant legislative requirements for advertising such goods must be complied with.

“Indirect intent” in this context does not refer to the explicit intention of the party responsible for the content, but rather to what a reasonable consumer might infer as the intent behind the content. Terms such as “plant-based medicine,” “plant medicine,” “cannabidiol” and “CBD oil,” which relate to medical cannabis products, may be considered promotional if they suggest a connection to medicinal cannabis. Businesses promoting a health service must ensure they do not inadvertently advertise a prescription medicine in their marketing materials. If the consumer is encouraged to seek out a health service based on the therapeutic goods available, the content is likely to be regarded as an advertisement for those therapeutic goods.

For additional information, the Therapeutic Goods Administration has established the Medicinal Cannabis Hub, accessible at https://www.tga.gov.au/products/unapproved-therapeutic-goods/medicinal-cannabis-hub, and has also provided advertising guidance for businesses involved in the medicinal cannabis sector, which can be found at https://www.tga.gov.au/sites/default/files/advertising-guidance-businesses-involved-medicinal-cannabis-products.pdf. These resources are designed to assist both consumers and industry professionals in understanding their obligations.



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