A key linchpin in America's drug war establishment could soon be pulled, if medical marijuana advocates are successful before the U.S. Court of Appeals for the District of Columbia this week.

For the first time in more than 20 years, the court will launch headlong into a serious challenge of the Drug Enforcement Agency's (DEA) Schedule I classification of marijuana: a placement which has held for nearly two generations that, much like heroin, PCP and LSD, marijuana has no known medical value.

The lawsuit getting underway Tuesday in Washington, D.C. has been pending for more than a decade, and advocates were forced to sue the government a second time just to get a hearing. For many, the long-awaited day is more than just a chance to advocate for medical reform in court: it's a real shot at forever changing the nation's marijuana laws.

"The federal classification of marijuana as Schedule I has caused my fellow patients to be imprisoned, denied work, kicked out of housing, be denied the right to own a firearm, and to be removed from transplant lists," Michael Krawitz, executive director of Veterans for Medical Marijuana and a plaintiff in the case, told Raw Story during a recent conference call. "It prohibits my Veteran Affairs medical center doctor from recommending cannabis to me. Instead, the VA has explicitly relegated their sovereign power to treat veterans' medical conditions to various states."

Those states -- all 17 of them -- make up the nation's loosely knit patchwork of significant drug reforms, but there's little agreement among them on regulatory standards. Voters in seven more states will take up the issue at polls this November, and surveys suggest the vast majority of voters agree that doctors should be allowed to recommend marijuana to patients with certain medical conditions. In spite of this, there's still significant disagreement in the medical community as to whether smoked or vaporized marijuana should be thought of as a medicine, and the DEA has allowed fewer than 20 studies that look at the drug's effects when smoked.

A victory before the appeals court could be huge for medical marijuana advocates, and may even force the DEA to reschedule marijuana similarly to drugs like methamphetamine, cocaine and opium, which the government says do have some limited medical value despite their potential for abuse. That reclassification could open the floodgates to big pharmaceutical companies, which have been chomping at the bit for years to patent marijuana-based medicines many think could be used to treat a host of ailments, from chronic pain to neuropathy, anxiety, nausea, wasting syndrome and possibly even certain types of cancerous tumors.

Although the Schedule I placement of marijuana has been challenged before, there have been numerous scientific studies on the drug in the intervening decades that may help sway the court's opinion, including one in particular that somehow managed to secure the government's approval to look at smoked and vaporized marijuana. That study concluded with Dr. Donald I. Abrams, at the University of California San Francisco Medical Center, declaring that AIDS patients with neuropathic pain were able to effectively treat a host of symptoms by inhaling marijuana.

"In my practice every day as a cancer specialist, I see patients who have loss of appetite, nausea and vomiting from their chemotherapy, pain on or off of opiates, anxiety, depression and insomnia," Abrams said on a call. "For those patients, I'm able to recommend one medicine they can buy for all of those symptoms, as opposed to writing them five prescription drugs -- and that would be cannabis."

Numerous other studies cited by Americans for Safe Access, one of the key groups behind the lawsuit, purport to show that marijuana is also useful for treating the symptoms of multiple sclerosis pain and spasticity, post traumatic stress disorder, obsessive compulsive disorder, Tourette's syndrome, inflammation, diarrhea, bipolar disorder, chemical dependency on other substances, migraine headaches, epilepsy, spinal cord injuries, Alzheimer's disease, glaucoma and Parkinson's disease.

Additionally, the American Medical Association adopted a resolution in 2009 (PDF) that calls upon the federal government to consider reclassifying marijuana to allow for additional clinical research. "However, the patchwork of state-based systems that have been established for 'medical marijuana' is woefully inadequate in establishing even rudimentary safeguards that normally would be applied to the appropriate clinical use of psychoactive substances," the AMA's conclusions (PDF) warned. "The future of cannabinoid-based medicine lies in the rapidly evolving field of botanical drug substance development, as well as the design of molecules that target various aspects of the endocannabinoid system."

Since then, the American Nurses Association, the Lymphoma Foundation of America and the AIDS Action Council have all called for reforms in the nation's prohibitionist laws. A government-sponsored study in July put an exclamation point on their calls for change when it found that marijuana's profile actually appears to be closer to Schedule III drugs like codeine and dronabinol.

For its part, the Obama administration will go to court on Tuesday to defend the Schedule I placement of marijuana, even though the Office on National Drug Control Policy said in 2011 that "there may be medical value for some of the individual components of the cannabis plant." Gil Kerlikowske, President Barack Obama's drug czar, took that point even further in July, responding to a White House petition by claiming that the administration is "interested in the potential marijuana may have" in medicine.

Whether that will hold any weight with the appeals court remains to be seen.

"Medical marijuana patients are finally getting their day in court," Americans for Safe Access attorney Joe Elford added in an advisory. "This is a rare opportunity for patients to confront politically motivated decision-making with scientific evidence of marijuana's medical efficacy. What's at stake in this case is nothing less than our country's scientific integrity and the imminent needs of millions of patients."


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