미국에서의 의료용 마리화나 합법화의 시사점 = The Implications of Legalization of Medical Marijuana in America

국문 초록 (Abstract)

1996년 미국 캘리포니아주를 시작으로 현재까지 미국 내 28개 주와 워싱턴 D.C.가 의료용 마리화나를 합법화 하였다. 이처럼 마리화나에 대한 법적 규제가 급격한 변화를 보이는 것은 마리화나가 가지는 의학적 효용에 기인한다. 마리화나는 특히 신경장애나 손상으로 인한 통증, 예컨대 메스꺼움, 발작, 녹내장, 활동장애 등의 치료에 효과가 있을 뿐만 아니라 파킨슨 병으로 인한 떨림을 완화시키고 다발성 경화증과 만성 염증성 질환인 크론병으로 인한 고통을 경감시켜주는 것으로 알려져 있다. 반면에 마리화나는 코카인이나 필로폰과 같은 위험한 마약에 빠지는 통로로서 역할을 할 수 있으며, 환각이나 쾌감 등을 주기 때문에 남용될 개연성으로 인해 연방법인 「규제약물법」 상 1급 마약으로 분류되어 있다. 2005년 미국연방대법원은 Gonzales v. Raich 사건에서 캘리포니아 주법인 「의료용 마리화나법」에 따라 의료용 마리화나를 적법하게 재배하더라도 마리화나 가격과 시장 조건에 영향을 미치게 되므로 「규제약물법」이 이들의 행위를 규제하는 것은 연방헌법상 주간통상조항에 위반되지 않는다고 하였다. 한편 미국 내 28개주와 워싱턴 D.C.는 의료용 마리화나를 합법화한 반면에 연방법인 「규제약물법」은 마리화나의 사용 등을 범죄로 규정하여 처벌하고 있기 때문에 여러 가지 법적인 문제들이 발행한다. 먼저 의료용 마리화나가 합법화된 주에 사는 주민이라도 연방법의 적용을 받는 시설, 예컨대 사회보장국 건물 등에서 마리화나를 소지하다가 적발되면 주법에 의해서 적법한 것이라도 연방법을 위반한 것으로서 형사처벌을 받게 된다. 둘째, 의료용 마리화나를 적법하게 이용하는 경우라도 자녀의 복리에 위해가 되는 경우에는 부모의 양육권을 제한당할 수 있다. 셋째, 공립학교에 다니는 학생의 경우 학교당국이 연방법에 위반된다는 이유로 의료용 마리화나의 사용에 협조하지 않아 학생의 학습권에 제약이 발생하기도 한다. 넷째, 근로자가 작업시간외에 의료용으로 마리화나를 사용했음에도 불구하고 직장에서 실시하는 소변검사에서 양성반응을 보여서 해고되는 사례가 발생하고 있다. 이러한 법적인 문제들은 미국이 연방국가로서 이중적인 법체계를 가지고 있다는 데에서 기인하는 것이지만, 우리는 마리화나의 의학적 효용과 가치에 주목해야 할 것이다. 특히 마리화나는 종류가 매우 많고, 이를 투여 내지 이용하는 방법도 다양하므로 기존의 약물로는 치료가 어려운 각종 질병에 대한 의학적인 효용에 관한 장기간의 연구와 실험이 필요하다.

다국어 초록 (Multilingual Abstract)

Until now 28 States and Washington D.C. has legalized medical marijuana since California legalized it for the first time as of 1996 in the United States. This radical change toward the legal regulation of marijuana results from the medical benefits from using it. It is said that marijuana can play a critical role in controlling neuropathic pain including nausea, spasticity, glaucoma and movement disorder, and can relieve the tremor of the Parkinson`s disease and the pain of the Crohn`s disease. In contrast, marijuana has been classified as a Schedule 1 Controlled Substance under the Controlled Substance Act (CSA) not only because it can be a gateway to the hard narcotics such as cocaine and methamphetamine, but also because it has abuse potential due to its hallucination or pleasant feeling. In 2005, the Supreme Court of the U.S. decided that “application of CSA provisions criminalizing manufacture, distribution, or possession of marijuana to intra-state growers and users of marijuana for medical purposes did not violate Commerce Clause” under the U.S. Constitution since their private growth of marijuana affected price and trade conditions in the marijuana market even though they grew it legally under the California statute. There are some legal problems caused by the fact that 28 States and Washington D.C. has legalized medical marijuana but the federal law, CSA, still punishes its use and possession as a crime. First, citizens who live in a State where medical marijuana is legal can be offenders when they are searched and found to be in possession of marijuana in a federal building such as the Social Security Administration office even though medical marijuana is legal under the State statute. Second, parents may lose custody of their child if the child was harmed by the use of marijuana by them even though they legally used it under the State statutes. Third, public school students may have some disadvantages regarding their right to study because public schools are not cooperative with the students who are prescribed medical marijuana, which is still illegal under CSA. Fourth, disabled employees who used medical marijuana are being fired for using it outside the workplace due to the positive urine drug tests. In sum, these legal problems may caused by the fact that America has the dual legal systems, the federal and the state legal systems, but we should pay attention to the medical benefits and values of marijuana. In particular, long-term study and tests are necessary with regard to the medical utility for the disease which is not easy to treat with the existing medicine because there are many different kinds of marijuana and the methods of its administration and use vary.

참고문헌 (Reference)

1 지제근, "의학용어 큰사전" 아카데미아 2002

2 "브리태니커 세계 대백과사전, 제7권" 2002

3 "브리태니커 세계 대백과사전, 제4권" 2002

4 한주희, "미국의 근로자 약물검사 및 마리화나 합법화에 관한 논쟁" 13 (13): 2015

5 신의기, "마약류 지정기준에 관한 연구" 형사정책연구원 2003

6 남궁현, "마리화나 정책 변화의 고찰: 콜로라도 마리화나 합법화의 경우" 한국형사정책연구원 25 (25): 1-28, 2014

7 이영미, "대마초사건, 그 1975년의 의미" 역사문제연구소 (112) : 206-231, 2015

8 Retzky, Sandra S., "What Can Go Wrong With Medical Marijuana?: A Legal Check-up Approach for Low-Income Clients Who Use Medical Marijuana" 6 : 1-, 2015

9 Aaron Glantz, "VA's Opiate Overload Feeds Veterans' Addictions, Leading to Overdose Deaths"

10 Goodwin, Robert S., "Urinary Elimination of 11-Nor-9-carboxy- 9-tetrahydrocannnabinol in Cannabis Users During Continuously Monitored Abstinence" 32 : 562-, 2008

11 Fleming, Marka B., "The Unthinkable Choice: The Constitutional Due Process Right To Parent Or The Legal Right To Use Medical Marijuana" 25 : 299-, 2016

12 "The Delaware Department Of Health And Social Service, Medical Marijuana Compassion Centers"

13 FDA, "THE CONTROLLED SUBSTANCE ACT"

14 Charmie Gholson, "TAC: Medical Marijuana Parents Association Formed; Defends Ingham County Single Father with Epilepsy"

15 "Substance Abuse and Mental Health Services Administration"

16 Governing The State And Localities, "State Marijuana Laws Map"

17 Patrick Whittle, "Schools Start To Grapple With Medical Marijuana Use By Students As Policy Lags Behind Acceptance"

18 Titus, Dina, "Puff, Puff, Pass ... That Law: The Changing Legislative Environment Of Medical Marijuana Policy" 53 : 39-, 2016

19 Harvey, Kathleen, "Protecting Medical Marijuana Users In The Workplace" 66 : 209-, 2015

20 "ProCon.org, 28 Legal Medical Marijuana States and DC" Laws, Fees, and Possession Limits

21 ProCon.org, "ProCon.org, 28 Legal Medical Marijuana States and DC" Laws, Fees, and Possession Limits

22 "Parents Seek Help for Son Autism and Recurring Behavioral Crises"

23 The Encyclopedia of American Politics, "Oregon Medical Marijuana, Measure 67"

24 Matt Ferner, "New Proposal Could Make It Easier To Research Medical Benefits Of Marijuana"

25 The Encyclopedia of American Politics, "Nevada Medical Marijuana Act, Question 9"

26 Warning Network, "National Estimates Of Drug-Related Emergency Department Visits"

27 Susan K. Livio, "N.J. Lawmakers Push Bill Allowing Sick Kids To Use Medical Marijuana Oil In School"

28 Susan K. Livio, "N.J. Family In Medical Marijuana Dispute With School Appears On ‘The View,’"

29 Christina Lobrutto, "N.J. Bill Would Allow Sick Kids To Use Medical Marijuana Oil In School"

30 Emily Wax-Thibodeaux, "More Veterans Press VA to Recognize Marijuana as Treatment Option"

31 James M. Cole, "Memorandum For United States Attorneys: Guidance Regarding The Ogden Memo In Jurisdictions Seeking To Authorize Marijuana For Medical Use"

32 David W. Ogden, "Memorandum For Selected United States Attorneys On Investigations And Prosecutions In States Authorizing The Medical Use Of Marijuana"

33 James M. Cole, "Memorandum For All United States Attorneys: Guidance Regarding Marijuana Enforcement"

34 Aggarwal, Sunil K., "Medicinal Use Of Cannabis In The United States: Historical Perspectives, Current Trends, And Future Directions" 5 : 153-, 2009

35 Gregory Carter, "Medicinal Cannabis: Rational Guidelines for Dosing"

36 Dave Smith, "Medical Marijuana: 10 Health Benefits that Legitimize Legalization"

37 The Delaware Department Of Health And Social Service, "Medical Marijuana Patients And Caregivers, Qualifying Debilitating Medical Conditions"

38 Retzky, Sandra, "Maryland’s Medical Marijuana Bills" 3 : 20-, 2010

39 Science Daily, "Marijuana Smoke Contains Higher Levels Of Certain Toxins Than Tobacco Smoke"

40 Irimescu, Silvia, "Marijuana Legalization: How Government Stagnation Hinders Legal Evolution And Harms A Nation" 50 : 241-, 2015

41 Hakalovic, Ajla, "Marijuana And Public Schools--The Talk Has Changed" 45 : 443-, 2016

42 Stimson, Charles D., "Legalizing Marijuana: Why Citizens Should Just Say No" THE HERITAGE FOUNDATION (56) : 2010

43 Busse, Franziska, "Lead Poisoning Due To Adulterated Marijuana" 358 : 1641-, 2008

44 Mkrtchyan, Vitaliy, "Initiative 692, Now and Then: The Past, Present, and Future of Medical Marijuana in Washington State" 47 : 839-, 2012

45 The U.S. Department Of Veterans Affairs, "How Common is PTSD?"

46 Hoff, Charles G., Jr., "Drug Abuse" 51 : 147-, 1971

47 DEA, "DRUG SCHEDULES"

48 Williams, John C., "Constitutionality Of State Legislation Imposing Criminal Penalties For Personal Posession Or Use Of Marijuana" 96 : 225-, 2016

49 "Compassionate Access, Research Expansion, and Respect States Act of 2015" 683 : 2015

50 Andrew Appelboam, "Coma Due To Cannabis Toxicity In An Infant"

51 Hickox, Stacy A., "Clearing the Smoke on Medical Marijuana Users in the Workplace" 29 : 1001-, 2011

52 Celeste Whitaker, "Christie Passes Medical Marijuana Bill"

53 Andy Balaskovitz, "Cannabis or Custody?, CITYPULSE"

54 Reed Hellman, "Cannabis Inc.: The Slow Road To Legal Usage"

55 The Encyclopedia of American Politics, "California Proposition 215"

56 Tom Cramer, "By The Numbers: VA Making Progress in Reducing Opioid Use in Veteran Patients"

57 Ashley Woods, "Baby Bree Green Returned To Parents, Medical Marijuana Patients, After Custody Seizure"

58 "Art Swift, Support For Legal Marijuana Use Up To 60% In U.S" Gallup

59 Arizona Medical Marijuana Program, "Arizona Medical Marijuana Active Qualifying Patients, Designated Caregivers and Dispensary Agents Profile" 2016

60 Lewis, Paul, "A Gateway To Future Problems: Concerns About The State-By-State Legalization Of Medical Marijuana" 13 : 49-, 2015

61 Jennifer Welsh, "23 Health Benefits of Marijuana"

62 Nefi Alarcon, "22 Veterans Kill Themselves Every D"

63 Bronstein, Alvin C., "2011 Annual Report Of The American Association Of Poison Control Centers’ National Poison Data System (NPDS): 29th Annual Report" 50 : 911-, 2012