Editor’s Note: This is the last post in our series from the Cannabis: Global Histories conference, held at the University of Strathclyde from April 19-20, 2018. It comes from Lucia Romero, an assistant researcher at CONICET (Argentina’s National Scientific and Technical Research Council). In it, she explores the grassroots groups that overcame decades of prohibition to increase access to medical marijuana in Argentina. Enjoy!
This paper discusses the rise of therapeutic cannabis use in Argentina. Through documentary work and personal interviews, our sociological approach focuses on how users (patients, growers) and experts (scientists, doctors, lawyers) produce and exchange different types of knowledge related to this medicine.
Our starting point was the recent medicinal cannabis law sanctioned in Argentina. Although cannabis has been socially signified as a drug and ruled illegal in the country for decades, over the course of two years, we have seen an accelerated process of social, medical, scientific and political legitimation of medicinal cannabis, which was concluded with the approval of a national law in March 2017. This law stipulates a regulatory framework for medical and scientific research and administrative resources to import cannabis oil for epilepsy patients, while private and designated cultivation remains illegal. This topic was, and is still, a central cause of conflict and political fights carried out by activists for health cannabis, as they and the growers are excluded from the law (many activists for health cannabis practice and promote self cultivation).
Patients and their families were the first to be against the prohibition of the use of marijuana and, in some cases, of its cultivation. They began trying cannabis to help their children (the group of patients and relatives we work with use cannabis as medicine against acute forms of epilepsy), most of them without medical guidance and in many cases, with medical disapproval. The patients and their relatives quickly joined together, creating collective organization with an activist identity. The two most popular organizations, Mamá Cultiva and CAMEDA (Cannabis Medicinal Argentina), have spread across the country in a very short period of time (3 years), reaching almost every province. Observation and personal records of their children´s response kept by the mothers gave them knowledge about the effects of cannabis on their children. They not only gathered this empirical evidence and got to know the plant, its strains and effects, and the variety of oils (with the help of growers), but they also searched for information through international bibliography specialized in the subject. Each patient association has their own growers, with whom they work on production, access and distribution of oils as they also have a group of doctors which gives support to these handcrafted treatments.
We have also seen the emergence of different types of collective actions, partnerships which establish horizontal and collaborative relationships with the medical community, as CAMEDA; while others more prone to opposing and confrontational relationships, as it is Mamá Cultiva (Rabeharisoa y Callon, 1998). In agreement with Epstein (1995), through these associations, we have observed the ability of patients to obtain institutional representation, to bring the knowledge they exchanged with doctors into play, and thus influence the decisions made regarding their treatments. An expertise based on the cognitive interaction among specialists, growers and patients, where takes place technical knowledge and experiences (source of personal and traditional knowledge), is in the core of the type of collective action driven by these associations.
Some doctors were pioneers in joining this patients´ movement, becoming specialized abroad and beginning observational studies at public hospitals in order to prove the effect of this innovative medicine, while at many public universities basic scientists started research agendas and technicians initiated chromatography studies to identify and classify plants. In both cases these practices were carried out in collaboration with growers.
Growers have the homemade and traditional knowledge of the plant, of its cultivation conditions, its care and growth, of the flower extraction (harvest), as well as its effects. In most cases, the cognitive relationship with the plant’s medicinal properties was initiated by request of patients with different illnesses. They have also joined different associations, being the most popular FOCA (Frente de Organizaciones Cannábicas). They are consulted not only by user-patients but also by experts (doctors and scientists) and technicians. As a result of this process the traditional hierarchical expert-lay authority is inverted.
Another central actor in this story are the lawyers. They guided the inception process of the patients´ organizations and act in defense of growers or patients that are arrested. Some lawyers worked collectively even before the beginning of the fight for medical cannabis legalization. Ten years ago, through THC Magazine, they started to communicate the idea of decriminalizing all kind of cannabis use (not only medical) and personal use of other drugs.
In sum, among those referred to as experts, we find doctors, lawyers and scientists, most of whom began to work more openly with medicinal cannabis issues after the law, in March 2017. The majority of the cases that they had worked with previously, had been dealt “under the table.” The role of the experts was essential at several occasions. With their specialized knowledge and their distinguished public authority, they gave legitimacy to patients and growers. But, on another hand, many experts who had oriented their agendas towards the benefits of cannabis as therapy obtained renewed scientific, political and social acceptance for the innovative utility of their research.
The exchange between doctors and patient associations revolves around searching for the best treatment (dosage, plant strain, carrier) for each one of the patients, leading to a work dynamic that is symmetrical and horizontally cooperative between professionals and patients, in which the latter’s experience is central to decision making related to their treatments (dosage, plant strain, carrier). These dynamics led to methods of knowledge co-production between users and experts, in which the latter assimilated and gave new meaning to the users’ knowledge, translating them into their technical-scientific language and stabilizing treatments along with their patients’ knowledge.
In these flows of interaction, among growers, between themselves as well as with the patients’ associations, with the doctors, between patients and doctors, lawyers and associations and growers, we have confirmed that cognitive influence has been exerted many times by those who could be considered “less of an expert,” as in the case of doctors who approach growers to learn about the plant, its effects, how to take care of it; as well as when doctors plan the treatments (dosage, strains, carrier) taking into consideration the patients’ stories, impressions, opinions, experiences, together with the evidence provided by the specialized literature.
We believe that this story matters because it shows how in Argentina the medicalization of marijuana was the result of a bottom up process where patients put pressure on experts to get them involved in building research agendas, legislation, administrative resources and social legitimacy related to medical cannabis.