Raich v. Gonzales ( 2007 )


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  •                     FOR PUBLICATION
    UNITED STATES COURT OF APPEALS
    FOR THE NINTH CIRCUIT
    ANGEL MCCLARY RAICH; JOHN DOE,            
    Number One; JOHN DOE, Number
    Two,
    Plaintiffs-Appellants,
    No. 03-15481
    v.
    ALBERTO R. GONZALES, Attorney                    D.C. No.
    CV-02-04872-MJJ
    General, as United States Attorney
    OPINION
    General; KAREN TANDY,* as
    Administrator of the Drug
    Enforcement Administration,
    Defendants-Appellees.
    
    Appeal from the United States District Court
    for the Northern District of California
    Martin J. Jenkins, District Judge, Presiding
    Argued and Submitted
    March 27, 2006—Pasadena, California
    Filed March 14, 2007
    Before: Harry Pregerson, C. Arlen Beam,** and
    Richard A. Paez, Circuit Judges.
    Opinion by Judge Pregerson;
    Partial Concurrence and Partial Dissent by Judge Beam
    *Karen Tandy is substituted for her predecessor, Asa Hutchinson, as
    Administrator of the Drug Enforcement Administration, pursuant to Fed.
    R. App. P. 43(c)(2).
    **The Honorable C. Arlen Beam, Senior United States Circuit Judge
    for the Eighth Circuit, sitting by designation.
    3025
    RAICH v. GONZALES                 3029
    COUNSEL
    Robert A. Raich, (briefed) Oakland, California and Randy E.
    Barnett, (argued) Boston University School of Law, Boston,
    Massachusetts, for the plaintiffs-appellants.
    Mark T. Quinlivan, Assistant United States Attorney, Boston,
    Massachusetts, for the defendants-appellees.
    3030                  RAICH v. GONZALES
    OPINION
    PREGERSON, Circuit Judge:
    Plaintiff-Appellant Angel McClary Raich (“Raich”) is a
    seriously ill individual who uses marijuana for medical pur-
    poses on the recommendation of her physician. Such use is
    permitted under California law. The remaining plaintiffs-
    appellants assist Raich by growing marijuana for her treat-
    ment.
    Appellants seek declaratory and injunctive relief based on
    the alleged unconstitutionality of the Controlled Substances
    Act, and a declaration that medical necessity precludes
    enforcement of the Controlled Substances Act against them.
    On March 5, 2003, the district court denied appellants’
    motion for a preliminary injunction. We hear this matter on
    remand following the Supreme Court’s decision in Gonzales
    v. Raich, 
    125 S. Ct. 2195
     (2005). For the reasons set forth
    below, we affirm the district court.
    STATUTORY SCHEMES
    I.   The Controlled Substances Act
    Congress passed the Comprehensive Drug Abuse Preven-
    tion and Control Act of 1970, Pub. L. No. 91-513, 
    84 Stat. 1236
    , to create a comprehensive drug enforcement regime it
    called the Controlled Substances Act, 
    21 U.S.C. § 801-971
    .
    Congress established five “schedules” of “controlled sub-
    stances.” See 
    21 U.S.C. § 802
    (6). Controlled substances are
    placed on a particular schedule based on their potential for
    abuse, their accepted medical use in treatment, and the physi-
    cal and psychological consequences of abuse of the substance.
    See 
    21 U.S.C. § 812
    (b). Marijuana is a Schedule I controlled
    substance. 
    21 U.S.C. § 812
    (c), Sched. I (c)(10). For a sub-
    stance to be designated a Schedule I controlled substance, it
    must be found: (1) that the substance “has a high potential for
    RAICH v. GONZALES                        3031
    abuse”; (2) that the substance “has no currently accepted med-
    ical use in treatment in the United States”; and (3) that
    “[t]here is a lack of accepted safety for use of the drug or
    other substance under medical supervision.” 
    21 U.S.C. § 812
    (b)(1). The Controlled Substances Act sets forth proce-
    dures by which the schedules may be modified. See 
    21 U.S.C. § 811
    (a).
    Under the Controlled Substances Act, it is unlawful to
    knowingly or intentionally “manufacture, distribute, or dis-
    pense, or possess with intent to manufacture, distribute, or
    dispense, a controlled substance,” except as otherwise pro-
    vided in the statute. 
    21 U.S.C. § 841
    (a)(1). Possession of a
    controlled substance, except as authorized under the Con-
    trolled Substances Act, is also unlawful. See 
    21 U.S.C. § 844
    (a).
    II.   California’s Compassionate Use Act of 1996
    California voters passed Proposition 215 in 1996, which is
    codified as the Compassionate Use Act of 1996
    (“Compassionate Use Act”). See 
    Cal. Health & Safety Code § 11362.5
    . The Compassionate Use Act is intended to permit
    Californians to use marijuana for medical purposes by
    exempting patients, primary caregivers, and physicians from
    liability under California’s drug laws. The Act explicitly
    states that its purpose is to
    ensure that seriously ill Californians have the right to
    obtain and use marijuana for medical purposes
    where that medical use is deemed appropriate and
    has been recommended by a physician who has
    determined that the person’s health would benefit
    from the use of marijuana in the treatment of cancer,
    anorexia, AIDS, chronic pain, spasticity, glaucoma,
    arthritis, migraine, or any other illness for which
    marijuana provides relief.
    3032                  RAICH v. GONZALES
    
    Id.
     § 11362.5(b)(1)(A). Another purpose of the Compassion-
    ate Use Act is “[t]o ensure that patients and their primary car-
    egivers who obtain and use marijuana for medical purposes
    upon the recommendation of a physician are not subject to
    criminal prosecution or sanction.” Id. § 11362.5(b)(1)(B). The
    Compassionate Use Act strives “[t]o encourage the federal
    and state governments to implement a plan to provide for the
    safe and affordable distribution of marijuana to all patients in
    medical need of marijuana.” Id. § 11362.5(b)(1)(C).
    To achieve its goal, the Compassionate Use Act exempts
    from liability under California’s drug laws “a patient, or . . .
    a patient’s primary caregiver, who possesses or cultivates
    marijuana for the personal medical purposes of the patient
    upon the written or oral recommendation or approval of a
    physician.” Id. § 11362.5(d).
    FACTUAL & PROCEDURAL HISTORY
    Appellant Angel McClary Raich is a Californian who uses
    marijuana for medical treatment. Raich has been diagnosed
    with more than ten serious medical conditions, including an
    inoperable brain tumor, a seizure disorder, life-threatening
    weight loss, nausea, and several chronic pain disorders.
    Raich’s doctor, Dr. Frank Henry Lucido, testified that he had
    explored virtually every legal treatment alternative, and that
    all were either ineffective or resulted in intolerable side
    effects. Dr. Lucido provided a list of thirty-five medications
    that were unworkable because of their side effects.
    Marijuana, on the other hand, has proven to be of great
    medical value for Raich. Raich has been using marijuana as
    a medication for nearly eight years, every two waking hours
    of every day. Dr. Lucido states that, for Raich, foregoing mar-
    ijuana treatment may be fatal. As the district court put it,
    “[t]raditional medicine has utterly failed [Raich].” Raich v.
    Ashcroft, 
    248 F. Supp. 2d 918
    , 921 (N.D. Cal. 2003).
    RAICH v. GONZALES                      3033
    Raich is unable to cultivate marijuana for her own use.
    Instead, Raich’s caregivers, John Doe Number One and John
    Doe Number Two, cultivate it for her. They provide mari-
    juana to Raich free of charge. They have joined this action as
    plaintiffs anonymously in order to protect Raich’s access to
    medical marijuana.
    This action arose in response to a law enforcement raid on
    the home of another medical marijuana user, former plaintiff-
    appellant Diane Monson.1 On August 15, 2002, Butte County
    Sheriff’s Department deputies, the Butte County District
    Attorney, and agents from the federal Drug Enforcement
    Agency (“DEA”) came to Monson’s home. After DEA agents
    took control of Monson’s six marijuana plants, a three-hour
    standoff between state and federal authorities ensued. The
    Butte County deputies and district attorney concluded that
    Monson’s use of marijuana was legal under the Compassion-
    ate Use Act. The DEA agents, after conferring with the U.S.
    Attorney for the Eastern District of California, concluded that
    Monson possessed the plants in violation of federal law. The
    DEA agents seized and destroyed Monson’s six marijuana
    plants.
    Fearing raids in the future and the prospect of being
    deprived of their medicinal marijuana, Raich, Monson, and
    the John Doe plaintiffs sued the United States Attorney Gen-
    eral and the Administrator of the DEA in federal district court
    on October 9, 2002. The suit sought declaratory and injunc-
    tive relief. Specifically, plaintiffs-appellants argued: (1) that
    the Controlled Substances Act was unconstitutional as applied
    to them because the legislation exceeded Congress’s Com-
    merce Clause authority; (2) that through the Controlled Sub-
    stances Act, Congress impermissibly exercised a police power
    that is reserved to the State of California under the Tenth
    Amendment; (3) that the Controlled Substances Act unconsti-
    1
    Plaintiff-Appellant Monson withdrew from this action on December
    12, 2005.
    3034                  RAICH v. GONZALES
    tutionally infringed their fundamental rights protected by the
    Fifth and Ninth Amendments; and (4) that the Controlled
    Substances Act could not be enforced against them because
    their allegedly unlawful conduct was justified under the com-
    mon law doctrine of necessity.
    On October 30, 2002, the plaintiffs-appellants moved for a
    preliminary injunction. On March 4, 2003, the district court
    denied the motion by a published order. See Raich v. Ashcroft,
    
    248 F. Supp. 2d 918
    . The district court found that, “despite
    the gravity of plaintiffs’ need for medical cannabis, and
    despite the concrete interest of California to provide it for
    individuals like them,” the appellants had not established the
    required “ ‘irreducible minimum’ of a likelihood of success
    on the merits under the law of this Circuit.” Id. at 931.
    On December 16, 2003, we reversed and remanded this
    matter to the district court to enter a preliminary injunction.
    See Raich v. Ashcroft, 
    352 F.3d 1222
    , 1235 (9th Cir. 2003).
    We held that the plaintiffs-appellants had demonstrated a
    strong likelihood of success on the merits of their claim that
    the Controlled Substances Act, as applied to them, exceeded
    Congress’s Commerce Clause authority. See 
    id. at 1234
    . We
    did not reach plaintiffs-appellants’ remaining arguments in
    favor of the preliminary injunction. See 
    id. at 1227
    . The Gov-
    ernment timely petitioned the Supreme Court for a writ of cer-
    tiorari. The Supreme Court granted certiorari on June 28,
    2004. See Ashcroft v. Raich, 
    542 U.S. 936
     (2004).
    On June 6, 2005, the Supreme Court vacated our opinion
    and held that Congress’s Commerce Clause authority includes
    the power to prohibit purely intrastate cultivation and use of
    marijuana. See Gonzales v. Raich, 
    125 S. Ct. at 2215
    . The
    Court remanded the case to us to address plaintiffs-
    appellants’s remaining legal theories in support of a prelimi-
    nary injunction. See 
    id.
     On remand, Raich renews her claims
    based on common law necessity, fundamental rights protected
    by the Fifth and Ninth Amendments, and rights reserved to
    RAICH v. GONZALES                       3035
    the states under the Tenth Amendment. She also argues for
    the first time that the Controlled Substances Act, by its terms,
    does not prohibit her from possessing and using marijuana if
    permitted to do so under state law. We have jurisdiction over
    this interlocutory appeal under 
    28 U.S.C. § 1292
    (a)(1).
    STANDING & STANDARD OF REVIEW
    [1] To satisfy the requirements of constitutional standing,
    “the plaintiff must have suffered, or be threatened with, an
    actual injury traceable to the defendant and likely to be
    redressed by a favorable judicial decision.” Mujahid v. Dan-
    iels, 
    413 F.3d 991
    , 994 (9th Cir. 2005) (citing Spencer v.
    Kemna, 
    523 U.S. 1
    , 7 (1998)). Furthermore, the injury must
    be: (1) concrete and particularlized, and (2) actual or immi-
    nent, not conjectural or hypothetical. See United States v.
    Antelope, 
    395 F.3d 1128
    , 1132 (9th Cir. 2005).
    [2] We are convinced that the requirements of constitu-
    tional standing have been met here.2 Although Raich has not
    suffered any past injury, she is faced with the threat that the
    Government will seize her medical marijuana and prosecute
    her for violations of federal drug law. The threat posed by
    deprivation of her medical treatment is serious and concrete:
    Raich’s doctor testified that foregoing medical marijuana
    treatment might be fatal. The threat is not speculative or con-
    jectural: DEA agents previously seized and destroyed the
    medical marijuana of former plaintiff-appellant Diane Mon-
    son. Monson’s withdrawal from this action does not change
    the fact that DEA agents have — and may again — seize and
    destroy medical marijuana possessed by gravely ill Califor-
    nians, including Raich. Finally, it is clear that Raich’s threat-
    ened injury may be fairly traced to the defendants, and that a
    favorable injunction from this court would redress Raich’s
    threatened injury.
    2
    We also note that the Supreme Court did not question constitutional
    standing in this case. See Gonzales v. Raich, 
    125 S. Ct. 2195
    .
    3036                    RAICH v. GONZALES
    A district court’s decision regarding preliminary injunctive
    relief is subject to limited review. See Harris v. Bd. of Super-
    visors, 
    366 F.3d 754
    , 760 (9th Cir. 2004). The court should
    be reversed only if it abused its discretion or based its deci-
    sion on an erroneous legal standard or on clearly erroneous
    findings of fact. See 
    id.
     A preliminary injunction must be sup-
    ported by findings of fact, reviewed for clear error. See Haw-
    kins v. Comparet-Cassani, 
    251 F.3d 1230
    , 1239 (9th Cir.
    2001). The district court’s conclusions of law are reviewed de
    novo. See Brown v. Cal. Dep’t of Transp., 
    321 F.3d 1217
    ,
    1221 (9th Cir. 2003).
    DISCUSSION
    “The standard for granting a preliminary injunction bal-
    ances the plaintiff’s likelihood of success against the relative
    hardship to the parties.” Clear Channel Outdoor, Inc. v. City
    of Los Angeles, 
    340 F.3d 810
    , 813 (9th Cir. 2003). We have
    two different criteria for determining whether preliminary
    injunctive relief is warranted. “Under the traditional criteria,
    a plaintiff must show (1) a strong likelihood of success on the
    merits, (2) the possibility of irreparable injury to [the] plaintiff
    if preliminary relief is not granted, (3) a balance of hardships
    favoring the plaintiff, and (4) advancement of the public inter-
    est (in certain cases).” See Save Our Sonoran, Inc. v. Flowers,
    
    408 F.3d 1113
    , 1120 (9th Cir. 2005) (internal quotations omit-
    ted). We also use an alternative test whereby a court may
    grant the injunction if the plaintiff demonstrates either: (1) a
    combination of probable success on the merits and the possi-
    bility of irreparable injury, or (2) that serious questions are
    raised and the balance of hardships tips sharply in his favor.
    See 
    id.
    The two alternative formulations “represent two points on
    a sliding scale in which the required degree of irreparable
    harm increases as the probability of success decreases. They
    are not separate tests but rather outer reaches of a single con-
    tinuum.” Baby Tam & Co. v. City of Las Vegas, 154 F.3d
    RAICH v. GONZALES                         3037
    1097, 1100 (9th Cir. 1998) (internal quotation marks and cita-
    tions omitted).
    I.   Common Law Necessity
    Raich first argues that she has a likelihood of success on
    the merits of her claim that the common law doctrine of
    necessity bars the federal government from enforcing the
    Controlled Substances Act against her medically-necessary
    use of marijuana.3 Raich avers that she is faced with a choice
    of evils: to either obey the Controlled Substances Act and
    endure excruciating pain and possibly death, or violate the
    terms of the Controlled Substances Act and obtain relief from
    her physical suffering.
    The necessity defense “traditionally covered the situation
    where physical forces beyond the actor’s control rendered
    illegal conduct the lesser of two evils” and the actor had no
    “reasonable, legal alternative to violating the law.” United
    States v. Bailey, 
    444 U.S. 394
    , 410 (1980); see also 2 Wayne
    R. LaFave, Substantive Criminal Law § 10.1 at 116 (2d ed.
    2003 & Supp. 2005). As we have recognized,
    In some sense, the necessity defense allows us to act
    as individual legislatures, amending a particular
    criminal provision or crafting a one-time exception
    to it, subject to court review, when a real legislature
    would formally do the same under those circum-
    stances. For example, by allowing prisoners who
    escape a burning jail to claim the justification of
    necessity, we assume the lawmaker, confronting this
    problem, would have allowed for an exception to the
    law proscribing prison escapes.
    3
    We address Raich’s necessity claim before her constitutional substan-
    tive due process claim because “an Act of Congress ought not be con-
    strued to violate the Constitution if any other possible construction
    remains available.” Gilmore v. California, 
    220 F.3d 987
    , 998 (9th Cir.
    2000) (quoting NLRB v. Catholic Bishop, 
    440 U.S. 490
    , 500 (1979)).
    3038                        RAICH v. GONZALES
    United States v. Schoon, 
    971 F.2d 193
    , 196-97 (9th Cir.
    1991).
    The Supreme Court has recognized that a common law
    necessity defense exists even when a statute does not explic-
    itly include the defense. See Bailey, 
    444 U.S. at 425
     (Black-
    mun, J., dissenting) (having “no difficulty in concluding that
    Congress intended the defenses of duress and necessity to be
    available” to prison escape defendant); 
    id.
     at 415 n.11 (Rehn-
    quist, J., majority opinion) (noting that the majority’s “princi-
    pal difference with the dissent, therefore, is not as to the
    existence of [the necessity] defense but as to the importance
    of surrender as an element of it”).4
    A.     Whether Raich Satisfies the Requirements of the
    Common Law Necessity Defense5
    4
    Dicta in a recent Supreme Court decision questioned the ongoing vital-
    ity of common law necessity defense. The majority in United States v.
    Oakland Cannabis Buyers’ Cooperative, 
    532 U.S. 483
    , 490 (2001)
    (“Oakland Cannabis”), stated that “it is an open question whether federal
    courts ever have authority to recognize a necessity defense not provided
    by statute.” But the majority ultimately conceded that the “Court ha[d] dis-
    cussed the possibility of a necessity defense without altogether rejecting
    it.” 
    Id.
     (citing Bailey, 
    444 U.S. at 415
    ). Three Justices filed a separate con-
    currence in Oakland Cannabis, noting that “the Court gratuitously casts
    doubt on ‘whether necessity can ever be a defense’ to any federal statute
    that does not explicitly provide for it, calling such a defense into question
    by a misleading reference to its existence as an ‘open question.’ ” 
    Id. at 501
     (Stevens, J., concurring) (quoting majority opinion) (emphasis in orig-
    inal). “[O]ur precedent has expressed no doubt about the viability of the
    common-law defense, even in the context of federal criminal statutes that
    do not provide for it in so many words.” 
    Id.
     (citing Bailey, 
    444 U.S. at 415
    ).
    We do not believe that the Oakland Cannabis dicta abolishes more than
    a century of common law necessity jurisprudence. See, e.g., Regina v.
    Dudley & Stephens, 14 Q.B.D. 273 (1884).
    5
    As the Supreme Court did in Oakland Cannabis, we first address the
    underlying principles of the common law necessity defense, and then turn
    to the defense’s relationship to the Controlled Substances Act and the
    relief sought. See, e.g., Oakland Cannabis, 
    532 U.S. at 490-95
    .
    RAICH v. GONZALES                         3039
    [3] Here, although we ultimately conclude that Raich is not
    entitled to injunctive relief on the basis of her common law
    necessity claim, we briefly note that, in light of the compel-
    ling facts before the district court, Raich appears to satisfy the
    threshold requirements for asserting a necessity defense under
    our case law. We have set forth the following general stan-
    dards for a necessity defense:
    As a matter of law, a defendant must establish the
    existence of four elements to be entitled to a neces-
    sity defense: (1) that he was faced with a choice of
    evils and chose the lesser evil; (2) that he acted to
    prevent imminent harm; (3) that he reasonably antic-
    ipated a causal relation between his conduct and the
    harm to be avoided; and (4) that there were no other
    legal alternatives to violating the law.
    United States v. Aguilar, 
    883 F.2d 662
    , 693 (9th Cir. 1989).
    We first ask whether Raich was faced with a choice of evils
    and whether she chose the lesser evil. Raich’s physician pres-
    ented uncontroverted evidence that Raich “cannot be without
    cannabis as medicine” because she would quickly suffer “pre-
    cipitous medical deterioration” and “could very well” die. If
    Raich obeys the Controlled Substances Act she will have to
    endure intolerable pain including severe chronic pain in her
    face and jaw muscles due to temporomandibular joint dys-
    function and bruxism, severe chronic pain and chronic burn-
    ing from fibromyalgia that forces her to be flat on her back
    for days, excruciating pain from non-epileptic seizures, heavy
    bleeding and severely painful menstrual periods due to a uter-
    ine fibroid tumor, and acute weight loss resulting possibly in
    death due to a life-threatening wasting disorder.6 Alterna-
    6
    This litany of ailments makes no mention of the fact that Raich was
    confined to a wheelchair before she found effective pain management in
    marijuana, which restored her ability to walk. The seriousness of her con-
    ditions cannot be overemphasized: in 1997, the extreme physical and psy-
    3040                       RAICH v. GONZALES
    tively, Raich can violate the Controlled Substances Act and
    avoid the bulk of those debilitating pains by using marijuana.
    The evidence persuasively demonstrates that, in light of her
    medical condition, Raich satisfies the first prong of the neces-
    sity defense.
    [4] We next ask whether Raich is acting to prevent immi-
    nent harm. All medical evidence in the record suggests that,
    if Raich were to stop using marijuana, the acute chronic pain
    and wasting disorders would immediately resume. The Gov-
    ernment does not dispute the severity of her conditions or the
    likelihood that her pain would recur if she is deprived of mari-
    juana. Raich has therefore established that the harm she faces
    is imminent.
    [5] Prong three asks whether Raich reasonably anticipated
    a causal connection between her unlawful conduct and the
    harm to be avoided. We believe that Raich’s belief in the
    causal connection is reasonable. Here, Raich’s licensed physi-
    cian testified to the causal connection between her physical
    condition and her need to use marijuana. The Government did
    not dispute this medical evidence. Because Raich has clearly
    demonstrated the medical correlation, she has satisfied prong
    three.7
    chological pain led Raich to attempt suicide. We are mindful that “extreme
    pain totally occupies the psychic world” and that “in serious pain the
    claims of the body utterly nullify the claims of the world.” Seth F.
    Kreimer, The Second Time as Tragedy: The Assisted Suicide Cases and
    the Heritage of Roe v. Wade, 
    24 Hastings Const. L.Q. 863
    , 895 & n.157
    (1997) (citations omitted). Raich has shown remarkable fortitude in pursu-
    ing this action to vindicate the rights of the infirm despite her precarious
    physical condition.
    7
    The causal connection prong limits the danger that a medical necessity
    exception could open the floodgates to widespread exceptions to the Con-
    trolled Substances Act. A marijuana “necessity” claimant absolutely must
    present, as Raich has, testimony that the allegedly unlawful action was
    taken at the direction of a doctor.
    RAICH v. GONZALES                           3041
    [6] Finally, we ask whether Raich had any legal alternatives
    to violating the law. Dr. Lucido’s testimony makes clear that
    Raich had no legal alternatives: Raich “has tried essentially
    all other legal alternatives to cannabis and the alternatives
    have been ineffective or result in intolerable side effects.”
    Raich’s physician explained that the intolerable side effects
    included violent nausea, shakes, itching, rapid heart palpita-
    tions, and insomnia. We agree that Raich does not appear to
    have any legal alternative to marijuana use.8
    [7] Although Raich appears to satisfy the factual predicate
    for a necessity defense, it is not clear whether the Supreme
    Court’s decision in United States v. Oakland Cannabis Buy-
    ers’ Cooperative forecloses a necessity defense to a prosecu-
    tion of a seriously ill defendant under the Controlled
    Substances Act. 
    532 U.S. 483
    , 484 n.7 (2001). Similarly,
    whether the Controlled Substances Act encompasses a legisla-
    tive “determination of values,” 
    id. at 491
    , that would preclude
    a necessity defense is also an unanswered question. These are
    difficult issues, and in light of our conclusion below that
    Raich’s necessity claim is best resolved within the context of
    a specific prosecution under the Controlled Substances Act,
    where the issue would be fully joined, we do not attempt to
    answer them here.
    8
    The Government suggests that certain federal programs exist which
    might allow Raich to obtain marijuana lawfully. See, e.g., 
    21 U.S.C. § 823
    (f) (authorizing the Secretary of Health and Human Services to per-
    mit medical practitioners to design and implement research protocols
    using Schedule I substances, including marijuana, on a case-by-base
    basis). Amici curiae American Civil Liberties Union Foundation and Mar-
    ijuana Policy Project and Rick Doblin, Ph.D make abundantly clear that
    this is not a tenable “alternative.” The program is highly restricted and has
    not accepted new medical marijuana patients since 1992.
    3042                  RAICH v. GONZALES
    B.   Whether a Viable Necessity Defense Gives Raich a
    Likelihood of Success on the Merits on this Action for
    Injunctive Relief
    Irrespective of the compelling factual basis for Raich’s
    necessity claim, whether Raich has a likelihood of success on
    the merits in this action for injunctive relief is a different
    question. We conclude that Raich has not demonstrated that
    she will likely succeed in obtaining injunctive relief on the
    necessity ground.
    [8] The necessity defense is an affirmative defense that
    removes criminal liability for violation of a criminal statute.
    See 2 LaFave, Substantive Criminal Law § 9.1(a) (2d ed.
    2003 & Supp. 2005). Necessity is essentially a justification
    for the prohibited conduct: the “harm caused by the justified
    behavior remains a legally recognized harm that is to be
    avoided whenever possible.” Paul H. Robinson, Criminal Law
    Defenses § 24(a) (1984 & Supp. 2006-2007). A common law
    necessity defense thus singles out conduct that is “otherwise
    criminal, which under the circumstances is socially acceptable
    and which deserves neither criminal liability nor even cen-
    sure.” LaFave, Substantive Criminal Law § 9.1(a)(3) (2d ed.
    2003 & Supp. 2005) (quotation omitted). The necessity
    defense serves to protect the defendant from criminal liability.
    [9] Though a necessity defense may be available in the con-
    text of a criminal prosecution, it does not follow that a court
    should prospectively enjoin enforcement of a statute. Raich’s
    violation of the Controlled Substances Act is a legally recog-
    nized harm, but the necessity defense shields Raich from lia-
    bility for criminal prosecution during such time as she
    satisfies the defense. Thus, if Raich were to make a miracu-
    lous recovery that obviated her need for medical marijuana,
    her necessity-based justification defense would no longer
    exist. Similarly, if Dr. Lucido found an alternative treatment
    that did not violate the law — a legal alternative to violating
    the Controlled Substances Act — Raich could no longer
    RAICH v. GONZALES                           3043
    assert a necessity defense. That is to say, a necessity defense
    is best considered in the context of a concrete case where a
    statute is allegedly violated, and a specific prosecution results
    from the violation. Indeed, oversight and enforcement of a
    necessity defense-based injunction would prove impractica-
    ble: the ongoing vitality of the injunction could hinge on fac-
    tors including Raich’s medical condition or advances in
    lawful medical technology. Nothing in the common law or
    our cases suggests that the existence of a necessity defense
    empowers this court to enjoin the enforcement of the Con-
    trolled Substances Act as to one defendant.
    [10] Because common law necessity prevents criminal lia-
    bility, but does not permit us to enjoin prosecution for what
    remains a legally recognized harm, we hold that Raich has not
    shown a likelihood of success on the merits on her medical
    necessity claim for an injunction.9
    II.   Substantive Due Process
    Raich contends that the district court erred by failing to
    protect her fundamental rights. Her argument focuses on
    unenumerated rights protected by the Fifth and Ninth Amend-
    ments to the Constitution under a theory of substantive due pro-
    cess.10
    9
    We cannot ignore that the unusual circumstances of this case raise the
    danger of acute preconviction harms. The arrest of Raich or her suppliers,
    or the confiscation of her medical marijuana would cause Raich severe
    physical trauma. Under the right circumstances, Raich might obtain relief
    from the courts for preconviction harm based on common law necessity.
    See generally Jones v. County of Los Angeles, 
    444 F.3d 1118
    , 1129-31
    (9th Cir. 2006) (noting that constitutionally cognizable harm can occur “at
    arrest, at citation, or even earlier,” and criticizing the government’s posi-
    tion that “would allow the state to criminalize a protected behavior or con-
    dition and cite, arrest, jail, and even prosecute individuals for violations,
    so long as no conviction resulted”).
    10
    We refer to these claims together as the substantive due process claim.
    3044                      RAICH v. GONZALES
    A.     Substantive Due Process, Generally
    [11] Although the Fifth Amendment’s Due Process Clause
    states only that “[n]o person shall . . . be deprived of life, lib-
    erty, or property, without due process of law,” see U.S. Const.
    amend. V, it unquestionably provides substantive protections
    for certain unenumerated fundamental rights.11 “The Due Pro-
    cess Clause guarantees more than fair process, and the ‘lib-
    erty’ it protects includes more than the absence of physical
    restraint.” Washington v. Glucksberg, 
    521 U.S. 702
    , 719
    (1997); see also Planned Parenthood of S.E. Penn. v. Casey,
    
    505 U.S. 833
    , 847 (1992) (“It is tempting, as a means of curb-
    ing the discretion of federal judges, to suppose that liberty
    encompasses no more than those rights already guaranteed to
    the individual against federal interference by the express pro-
    visions of the first eight Amendments to the Constitution. But
    of course this Court has never accepted that view.” (internal
    citation omitted)). As Justice Harlan put it over forty years
    ago:
    [T]he full scope of the liberty guaranteed by the Due
    Process Clause cannot be found in or limited by the
    precise terms of the specific guarantees elsewhere
    provided in the Constitution. This ‘liberty’ is not a
    series of isolated points pricked out in terms of the
    taking of property; the freedom of speech, press, and
    religion; the right to keep and bear arms; the free-
    dom from unreasonable searches and seizures; and
    so on. It is a rational continuum which, broadly
    11
    Although the Fifth Amendment’s Due Process Clause is applicable
    here, cases finding substantive rights under the Fourteenth Amendment’s
    Due Process Clause are equally relevant. See Troxel v. Granville, 
    530 U.S. 57
    , 65 (2000) (“We have long recognized that the Amendment’s Due Pro-
    cess Clause, like its Fifth Amendment counterpart, guarantees more than
    fair process. The Clause also includes a substantive component that pro-
    vides heightened protection against government interference with certain
    fundamental rights and liberty interests.” (emphasis added) (internal cita-
    tion and quotation marks omitted)).
    RAICH v. GONZALES                       3045
    speaking, includes a freedom from all substantial
    arbitrary impositions and purposeless restraints, and
    which also recognizes, what a reasonable and sensi-
    tive judgment must, that certain interests require par-
    ticularly careful scrutiny of the state needs asserted
    to justify their abridgment.
    Poe v. Ullman, 
    367 U.S. 497
    , 543 (1961) (Harlan, J., dissent-
    ing) (citations omitted); see also Casey, 
    505 U.S. at 849
     (not-
    ing that Justice Harlan’s position was adopted by the Court in
    Griswold v. Connecticut, 
    381 U.S. 479
     (1965)). These conten-
    tions find support in the Ninth Amendment, which provides
    that “[t]he enumeration in the Constitution, of certain rights,
    shall not be construed to deny or disparage others retained by
    the people.” U.S. Const. amend. IX.
    In Glucksberg, the Supreme Court set forth the two ele-
    ments of the substantive due process analysis.
    First, we have regularly observed that the Due Pro-
    cess Clause specially protects those fundamental
    rights and liberties which are, objectively, “deeply
    rooted in this Nation’s history and tradition,” and
    “implicit in the concept of ordered liberty,” such that
    “neither liberty nor justice would exist if they were
    sacrificed.” Second, we have required in substantive-
    due-process cases a “careful description” of the
    asserted fundamental liberty interest.
    Glucksberg, 
    521 U.S. at 720-21
     (citations omitted).
    The Supreme Court has a long history of recognizing
    unenumerated fundamental rights as protected by substantive
    due process, even before the term evolved into its modern
    usage. See, e.g., Casey, 
    505 U.S. 833
     (to have an abortion);
    Roe v. Wade, 
    410 U.S. 113
     (1973) (same); Eisenstadt v.
    Baird, 
    405 U.S. 438
     (1972) (to use contraception); Griswold,
    
    381 U.S. 479
     (to use contraception, to marital privacy); Lov-
    3046                  RAICH v. GONZALES
    ing v. Virginia, 
    388 U.S. 1
     (1967) (to marry); Rochin v. Cali-
    fornia, 
    342 U.S. 165
     (1952) (to bodily integrity); Skinner v.
    Oklahoma ex rel. Williamson, 
    316 U.S. 535
     (1942) (to have
    children); Pierce v. Society of Sisters, 
    268 U.S. 510
     (1925) (to
    direct the education and upbringing of one’s children); Meyer
    v. Nebraska, 
    262 U.S. 390
     (1923) (same). But the Court has
    cautioned against the doctrine’s expansion. See Glucksberg,
    
    521 U.S. at 720
     (stating that the Court must restrain the
    expansion of substantive due process “because guideposts for
    responsible decisionmaking in this uncharted area are scarce
    and open-ended” and because judicial extension of constitu-
    tional protection for an asserted substantive due process right
    “place[s] the matter outside the arena of public debate and
    legislative action” (citations omitted)); Reno v. Flores, 
    507 U.S. 292
    , 302 (1993) (noting that “[t]he doctrine of judicial
    self-restraint requires us to exercise the utmost care whenever
    we are asked to break new ground in this field” (quoting Col-
    lins v. Harker Heights, 
    503 U.S. 115
    , 125 (1992))).
    Bearing that rubric in mind, we consider Raich’s substan-
    tive due process claim. In the present case, it is helpful to
    begin with the second step — the description of the asserted
    fundamental right — before determining whether the right is
    deeply rooted in this nation’s history and traditions and
    implicit in the concept of ordered liberty.
    B.   Breadth of the Fundamental Right
    [12] Glucksberg instructs courts to adopt a narrow defini-
    tion of the interest at stake. See 
    521 U.S. at 722
     (“[W]e have
    a tradition of carefully formulating the interest at stake in
    substantive-due-process cases.”); see also Flores, 
    507 U.S. at 302
     (noting that the asserted liberty interest must be construed
    narrowly to avoid unintended consequences). Substantive due
    process requires a “careful description of the asserted funda-
    mental liberty interest.” Glucksberg, 
    521 U.S. at 721
     (quota-
    tion and citations omitted).
    RAICH v. GONZALES                    3047
    Glucksberg involved a substantive due process challenge to
    Washington state’s ban on assisted suicide. See 
    id. at 705-06
    .
    The Court in Glucksberg rejected the suggestion that the
    interest at stake was the “right to die” or “the right to choose
    a humane, dignified death,” and instead held that the narrow
    question before the Court was “whether the ‘liberty’ specially
    protected by the Due Process Clause includes a right to com-
    mit suicide which itself includes a right to assistance in doing
    so.” 
    Id. at 722-23
    .
    Another case that considered and rejected several asserted
    fundamental rights involved unaccompanied alien juveniles
    who are in the custody of immigration authorities. See Flores,
    
    507 U.S. at 294
    . The Flores Court rejected the proposed fun-
    damental right of “freedom from physical restraint” because
    it was not an accurate depiction of the true issue in the case.
    See Flores, 
    507 U.S. at 302
    . The Court also rejected the for-
    mulation of the “right of a child to be released from all other
    custody into the custody of its parents, legal guardian, or even
    close relatives.” 
    Id.
     Instead, the Flores Court examined the
    narrow “right of a child who has no available parent, close
    relative, or legal guardian, and for whom the government is
    responsible, to be placed in the custody of a willing-and-able
    private custodian rather than of a government-operated or
    government-selected child-care institution.” Id.; see also Law-
    rence v. Texas, 
    539 U.S. 558
    , 578 (2003) (recognizing nar-
    rowly defined fundamental right to engage in consensual
    sexual activity, including homosexual sodomy, in the home
    without government intrusion).
    C.   Raich’s Asserted Fundamental Interest
    Raich asserts that she has a fundamental right to “mak[e]
    life-shaping medical decisions that are necessary to preserve
    the integrity of her body, avoid intolerable physical pain, and
    preserve her life.” We note that Raich’s carefully crafted
    interest comprises several fundamental rights that have been
    recognized at least in part by the Supreme Court. See Law-
    3048                       RAICH v. GONZALES
    rence, 
    539 U.S. at 574
     (recognizing that “the Constitution
    demands [respect] for the autonomy of the person in making
    [personal] choices”); Casey, 
    505 U.S. at 849
     (noting impor-
    tance of protecting “bodily integrity”); 
    id. at 852
     (observing
    that a woman’s “suffering is too intimate and personal” for
    government to compel such suffering by requiring woman to
    carry a pregnancy to term).
    Yet, Raich’s careful statement does not narrowly and accu-
    rately reflect the right that she seeks to vindicate. Conspicu-
    ously missing from Raich’s asserted fundamental right is its
    centerpiece: that she seeks the right to use marijuana to pre-
    serve bodily integrity, avoid pain, and preserve her life.12 As
    in Glucksberg, Flores, and Cruzan, the right must be carefully
    stated and narrowly identified before the ensuing analysis can
    proceed. Accordingly, we will add the centerpiece — the use
    of marijuana — to Raich’s proposed right.13
    [13] Accordingly, the question becomes whether the liberty
    interest specially protected by the Due Process Clause
    embraces a right to make a life-shaping decision on a physi-
    cian’s advice to use medical marijuana to preserve bodily
    integrity, avoid intolerable pain, and preserve life, when all
    other prescribed medications and remedies have failed.
    D.     Whether the Asserted Right is “Deeply Rooted in This
    12
    This degree of specificity is required. In Cruzan v. Director, Mo.
    Dept. of Health, 
    497 U.S. 261
     (1990), the Court declined to frame the right
    as an unqualified right to die, and instead specifically construed the right
    as a “constitutionally protected right to refuse lifesaving hydration and
    nutrition.” 
    Id. at 279
    .
    13
    We also find persuasive the suggestion of amicus curiae California
    Medical Association and California Nurses Association: that the definition
    incorporate reference to the fact that Raich seeks to establish this right “on
    a physician’s advice.” We also think that resort to a Schedule I substance
    should be a last resort, and therefore narrow the right by limiting it to cir-
    cumstances “when all other prescribed medications have failed.”
    RAICH v. GONZALES                    3049
    Nation’s History and Tradition” and “Implicit in the
    Concept of Ordered Liberty”
    We turn to whether the asserted right is “deeply rooted in
    this Nation’s history and tradition,” and “implicit in the con-
    cept of ordered liberty,” such that “neither liberty nor justice
    would exist if they were sacrificed.” Glucksberg, 
    521 U.S. at 720-21
    .
    [14] It is beyond dispute that marijuana has a long history
    of use — medically and otherwise — in this country. Mari-
    juana was not regulated under federal law until Congress
    passed the Marihuana Tax Act of 1937, Pub. L. No. 75-348,
    
    50 Stat. 551
     (repealed 1970), and marijuana was not prohib-
    ited under federal law until Congress passed the Controlled
    Substances Act in 1970. See Gonzales v. Raich, 
    125 S. Ct. at 2202
    . There is considerable evidence that efforts to regulate
    marijuana use in the early-twentieth century targeted recre-
    ational use, but permitted medical use. See Richard J. Bonnie
    & Charles H. Whitebread, The Forbidden Fruit and the Tree
    of Knowledge: An Inquiry into the Legal History of American
    Marijuana Prohibition, 
    56 Va. L. Rev. 971
    , 1010, 1027, 1167
    (1970) (noting that all twenty-two states that had prohibited
    marijuana by the 1930s created exceptions for medical pur-
    poses). By 1965, although possession of marijuana was a
    crime in all fifty states, almost all states had created excep-
    tions for “persons for whom the drug had been prescribed or
    to whom it had been given by an authorized medical person.”
    Leary v. United States, 
    395 U.S. 6
    , 16-17 (1969).
    [15] The history of medical marijuana use in this country
    took an about-face with the passage of the Controlled Sub-
    stances Act in 1970. Congress placed marijuana on Schedule
    I of the Controlled Substances Act, taking it outside of the
    realm of all uses, including medical, under federal law. As the
    Supreme Court noted in Gonzales v. Raich, 
    125 S. Ct. at 2199
    , no state permitted medical marijuana usage until Cali-
    fornia’s Compassionate Use Act of 1996. Thus, from 1970 to
    3050                      RAICH v. GONZALES
    1996, the possession or use of marijuana — medically or oth-
    erwise — was proscribed under state and federal law.14
    Raich argues that the last ten years have been characterized
    by an emerging awareness of marijuana’s medical value. She
    contends that the rising number of states that have passed
    laws that permit medical use of marijuana or recognize its
    therapeutic value is additional evidence that the right is funda-
    mental. Raich avers that the asserted right in this case should
    be protected on the “emerging awareness” model that the
    Supreme Court used in Lawrence v. Texas, 
    539 U.S. at 571
    .
    The Lawrence Court noted that, when the Court had
    decided Bowers v. Hardwick, 
    478 U.S. 186
     (1986), “[twenty-
    four] States and the District of Columbia had sodomy laws.”
    Lawrence, 
    539 U.S. at 572
    . 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.” 
    Id. at 573
    . 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.” 
    Id. at 579
    .
    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 distri-
    bution of marijuana for the seriously ill. See 
    Alaska Stat. § 11.71.090
    ; 
    Colo. Rev. Stat. § 18-18-406.3
    ; 
    Haw. Rev. Stat. § 329-125
    ; 
    Me. Rev. Stat. Ann. tit. 22, § 2383
    -B; Mont. Code
    14
    The mere enactment of a law, state or federal, that prohibits certain
    behavior does not necessarily mean that the behavior is not deeply rooted
    in this country’s history and traditions. It is noteworthy, however, that
    over twenty-five years went by before any state enacted a law to protect
    the alleged right.
    RAICH v. GONZALES                         3051
    Ann. § 50-46-201; Nev. Rev. Stat. § 453A.200; 
    Or. Rev. Stat. § 475.319
    ; R.I. Gen. Laws § 21-28.6-4; Vt. Stat. Ann. tit. 18,
    § 4474b; 
    Wash. Rev. Code § 69
    .51A.040. Other states have
    passed resolutions recognizing that marijuana may have thera-
    peutic value, and yet others have permitted limited use
    through closely monitored experimental treatment programs.15
    [16] We agree with Raich that medical and conventional
    wisdom that recognizes the use of marijuana for medical pur-
    poses is gaining traction in the law as well. But that legal rec-
    ognition has not yet reached the point where a conclusion can
    be drawn that the right to use medical marijuana is “funda-
    mental” and “implicit in the concept of ordered liberty.” See
    Glucksberg, 
    521 U.S. at 720-21
     (citations omitted). For the
    time being, this issue remains in “the arena of public debate
    and legislative action.” 
    Id. at 720
    ; see also Gonzales v. Raich,
    
    125 S. Ct. at 2215
    .
    [17] As stated above, Justice Anthony Kennedy told us 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.” Lawrence, 
    539 U.S. at 579
    . 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 mari-
    15
    While these lesser endorsements of medical marijuana are relevant,
    they cannot carry the same weight as legislative enactments that fully
    decriminalize the use of medical marijuana. As the Lawrence Court con-
    sidered the number of states that retained laws that prohibited sodomy, so
    too must we consider the number of states that continue to prohibit medi-
    cal marijuana.
    3052                       RAICH v. GONZALES
    juana prescribed by a licensed physician to alleviate excrucia-
    ting pain and human suffering.16
    III.    Tenth Amendment
    Third, Raich contends that the Controlled Substances Act
    infringes upon the sovereign powers of the State of California,
    most notably the police powers, as conferred by the Tenth
    Amendment. The district court found that, as a valid exercise
    of Congress’s Commerce Clause powers, the Controlled Sub-
    stances Act could curtail the states’ exercise of their police
    powers without violating the Tenth Amendment. See Raich v.
    Ashcroft, 
    248 F. Supp. 2d at 927
    . The district court further
    held that the Controlled Substances Act regulates individual
    behavior and does not force the state to take any action. 
    Id.
    [18] The Tenth Amendment reads, in its entirety: “The
    powers not delegated to the United States by the Constitution,
    nor prohibited by it to the States, are reserved to the States
    respectively, or to the people.” U.S. Const. amend. X. Police
    power is unquestionably an area of traditional state control.
    Throughout our history the several States have exer-
    cised their police powers to protect the health and
    safety of their citizens. Because these are primarily,
    and historically, . . . matter[s] of local concern, the
    16
    Because we find no fundamental right here, we do not address
    whether any law that limits that right is narrowly drawn to serve a compel-
    ling state interest. See Flores, 
    507 U.S. at 301-02
    . We note, however, that,
    a recent Supreme Court case suggests that the Controlled Substances Act
    is not narrowly drawn when fundamental rights are concerned. See Gon-
    zales v. O Centro Espirita Beneficente Uniao do Vegetal, 
    126 S. Ct. 1211
    ,
    1221-23 (Feb. 21, 2006) (observing that “mere invocation of the general
    characteristics of Schedule I substances, as set forth in the Controlled Sub-
    stances Act, cannot carry the day,” and that the government had presented
    no evidence that narrow exceptions to the Schedule I prohibitions would
    undercut the government’s ability to effectively enforce the Controlled
    Substances Act).
    RAICH v. GONZALES                          3053
    States traditionally have had great latitude under
    their police powers to legislate as to the protection of
    the lives, limbs, health, comfort, and quiet of all per-
    sons.
    Medtronic, Inc. v. Lohr, 
    518 U.S. 470
    , 475 (1996) (internal
    citations and quotation marks omitted). The Compassionate
    Use Act, aimed at providing for the health of the state’s citi-
    zens, appears to fall squarely within the general rubric of the
    state’s police powers.
    Generally speaking, however, a power granted to Congress
    trumps a competing claim based on a state’s police powers.
    “The Court long ago rejected the suggestion that Congress
    invades areas reserved to the States by the Tenth Amendment
    simply because it exercises its authority under the Commerce
    Clause in a manner that displaces the States’ exercise of their
    police powers.” Hodel v. Va. Surface Mining & Reclamation
    Ass’n, 
    452 U.S. 264
    , 291 (1981); see also United States v.
    Jones, 
    231 F.3d 508
    , 515 (9th Cir. 2000) (“We have held that
    if Congress acts under one of its enumerated powers, there
    can be no violation of the Tenth Amendment.”).
    [19] The Supreme Court held in Gonzales v. Raich that
    Congress acted within the bounds of its Commerce Clause
    authority when it criminalized the purely intrastate manufac-
    ture, distribution, or possession of marijuana in the Controlled
    Substances Act. See 
    125 S. Ct. at 2215
    . Thus, after Gonzales
    v. Raich, it would seem that there can be no Tenth Amend-
    ment violation in this case. Raich concedes that recent
    Supreme Court decisions have largely foreclosed her Tenth
    Amendment claim, and she also concedes that this case does
    not implicate the “commandeering” line of cases.17
    17
    The commandeering cases involve attempts by Congress to direct
    states to perform certain functions, command state officers to administer
    federal regulatory programs, or to compel states to adopt specific legisla-
    tion. See, e.g., Printz v. United States, 
    521 U.S. 898
    , 935 (1997); New
    3054                       RAICH v. GONZALES
    The Supreme Court’s recent decision in Oregon v. Gon-
    zales, 
    126 S. Ct. 904
     (Jan. 17, 2006) is not to the contrary. In
    that case, the Court invalidated an Interpretive Rule issued by
    the Attorney General on the basis of statutory construction,
    not on the basis of constitutional invalidity under the Tenth
    Amendment. See 
    id. at 925
    . Because the Attorney General’s
    Rule was “incongruous with the statutory purposes and
    design” of the Controlled Substances Act, the Rule had to be
    nullified. 
    Id. at 921
     (emphasis added). Although Oregon v.
    Gonzales undoubtedly implicates federalism issues, its hold-
    ing is inapposite to Raich’s Tenth Amendment claim.
    [20] We hold that Raich failed to demonstrate a likelihood
    of success on her claim that the Controlled Substances Act
    violates the Tenth Amendment. Accordingly, the district court
    did not abuse its discretion in denying Raich’s motion for pre-
    liminary injunction on that basis.
    IV.    The Controlled Substances Act, By Its Terms
    Finally, Raich argues that the plain text of the Controlled
    Substances Act does not prohibit her from possessing mari-
    juana pursuant to a doctor’s order. She observes that the Con-
    trolled Substances Act prohibits possession of a controlled
    substance “unless such substance was obtained . . . pursuant
    to a valid prescription or order, from a practitioner, while act-
    ing in the course of his professional practice.” 
    21 U.S.C. § 844
    (a). The Controlled Substances Act defines “practition-
    er” as “a physician . . . licensed, registered, or otherwise per-
    mitted, by the United States or the jurisdiction in which he
    practices . . . to distribute, dispense, [or] administer . . . a con-
    York v. United States, 
    505 U.S. 144
    , 166 (1992). The Controlled Sub-
    stances Act, by contrast, “does not require the [state legislature] to enact
    any laws or regulations, and it does not require state officials to assist in
    the enforcement of federal statutes regulating private individuals.” Reno
    v. Condon, 
    528 U.S. 141
    , 151 (2000).
    RAICH v. GONZALES                           3055
    trolled substance in the course of professional practice.” 
    Id.
    § 802(21). Raich contends that her doctor is a licensed physi-
    cian who may, in the jurisdiction in which he practices,
    administer controlled substances, including marijuana under
    the Compassionate Use Act, pursuant to a valid prescription.
    Accordingly, she argues that her possession of marijuana is
    legal under the Controlled Substances Act.
    [21] Raich raises this argument for the first time in her
    opening brief to our second review of her case. It is a long-
    standing rule in the Ninth Circuit that, generally, “we will not
    consider arguments that are raised for the first time on
    appeal.” Smith v. Marsh, 
    194 F.3d 1045
    , 1052 (9th Cir. 1999).
    That rule is subject to the exceptions that we may consider a
    new issue if: (1) there are exceptional circumstances why the
    issue was not raised in the trial court; (2) the new issue arises
    while the appeal is pending because of a change in the law;
    or (3) the issue presented is a pure question of law and the
    opposing party will suffer no prejudice as a result of the fail-
    ure to raise the issue in the trial court. See United States v.
    Carlson, 
    900 F.2d 1346
    , 1349 (9th Cir. 1990).
    Raich does not address the waiver issue in her opening
    brief, nor does she cite any relevant exception that might
    apply to her argument. We observe that there do not appear
    to be any exceptional circumstances concerning why Raich
    did not raise the argument below, and that there has been no
    change in the law relevant to this argument. Thus, Raich’s
    only argument against waiver of this claim is that it is a purely
    legal question, and that the Government will suffer no preju-
    dice as a result of Raich’s failure to raise the issue below.18
    18
    We assess prejudice to a party by asking whether the party is in a dif-
    ferent position than it would have been absent the alleged deficiency. See
    Zhang v. Am. Gem Seafoods, Inc., 
    339 F.3d 1020
    , 1035 (9th Cir. 2003).
    The rule “serves to ensure that legal arguments are considered with the
    benefit of a fully developed factual record, offers appellate courts the ben-
    efit of the district court’s prior analysis, and prevents parties from sand-
    3056                      RAICH v. GONZALES
    Even if a case falls within one of the exceptions to waiver
    enunciated in Carlson, we must “still decide whether the par-
    ticular circumstances of the case overcome our presumption
    against hearing new arguments.” Dream Palace, 384 F.3d at
    1005. Although Raich’s Controlled Substances Act claim
    appears to fall within the third exception, we conclude that
    this claim is waived because of the “particular circumstances”
    surrounding the claim.
    [22] Raich failed to raise this claim before the district court
    and before this court in her appeal in Raich v. Ashcroft, 
    352 F.3d 1222
    . Furthermore, when we requested renewed briefing
    for this appeal by our order of September 6, 2005, we directed
    the parties to brief the “remaining claims for declaratory and
    injunctive relief on the basis of the Tenth Amendment, the
    Fifth and Ninth Amendments, and the doctrine of medical
    necessity, as set forth in their complaint.” Raich v. Gonzales,
    No. 03-15481 (9th Cir. Sept. 6, 2005) (order directing
    renewed briefing). Because Raich did not raise this issue
    below, and because our order instructed the parties to brief
    only the three claims set forth above, we hold that Raich’s
    claim based on the plain language of the Controlled Sub-
    stances Act is waived. We express no opinion as to the merits
    of that claim.
    CONCLUSION
    We conclude that Raich has not demonstrated a likelihood
    of success on the merits of her action for injunctive relief.
    First, we hold that Raich’s common law necessity defense is
    not foreclosed by Oakland Cannabis or the Controlled Sub-
    bagging their opponents with new arguments on appeal.” Dream Palace
    v. County of Maricopa, 
    384 F.3d 990
    , 1005 (9th Cir. 2004). It does not
    appear that the Government has suffered any prejudice from Raich’s fail-
    ure to raise this claim below: the Government is in the same position that
    it would have otherwise been.
    RAICH v. GONZALES                    3057
    stances Act, but that the necessity defense does not provide a
    proper basis for injunctive relief. Second, although changes in
    state law reveal a clear trend towards the protection of medi-
    cal marijuana use, we hold that the asserted right has not yet
    gained the traction on a national scale to be deemed funda-
    mental. Third, we hold that the Controlled Substances Act, a
    valid exercise of Congress’s commerce power, does not vio-
    late the Tenth Amendment. Finally, we decline to reach
    Raich’s argument that the Controlled Substances Act, by its
    terms, does not prohibit her possession and use of marijuana
    because this argument was not raised below.
    Accordingly, the judgment of the district court is
    AFFIRMED.
    BEAM, Circuit Judge, concurring and dissenting:
    I concur in the result reached by the court in this case, more
    particularly its holding that “Raich has not demonstrated a
    likelihood of success on the merits of her action for injunctive
    relief” and that the district court’s denial of an injunction
    should be affirmed. I dissent from the court’s expansive con-
    sideration of the doctrine of common law necessity as well as
    from several of the factual findings and legal conclusions
    applied to this issue and other claims before the court.
    DISCUSSION
    We should decide only the case that is properly before us,
    not any other, and we should leave for another day any claim
    or issue not ripe for consideration. When we do otherwise, we
    simply create obitur dictum. See, e.g., Carey v. Musladin, 
    127 S. Ct. 649
    , 655 (2006) (Stevens, J., concurring) (citing Sheet
    Metal Workers v. EEOC, 
    478 U.S. 421
    , 490 (1986)).
    This case returns to us on remand from the Supreme Court.
    But, the party that earlier supplied jurisdiction to the Supreme
    3058                   RAICH v. GONZALES
    Court and to this court, Diane Monson, has withdrawn. Ante
    at 3033 n.1. Thus, the facts concerning Ms. Monson gener-
    ously recited by the court are in no way relevant or material
    to the issues now raised by Raich. Accordingly, the court
    likely has no jurisdiction over any claim asserted by the plain-
    tiffs in this appeal but most certainly no jurisdiction to decide
    whether Raich may assert the doctrine of common law neces-
    sity in a future criminal prosecution.
    At oral argument, counsel for the parties conceded that
    there is not now pending nor has there ever been pending a
    prosecution or even a threatened prosecution of Raich for pos-
    session or use of personal amounts of medicinal marijuana.
    Indeed, counsel for Raich acknowledged at oral argument
    that, to his knowledge, there has never been a federal criminal
    prosecution for simple possession or use of medicinal mari-
    juana against anyone anywhere in California. Counsel for the
    government likewise indicated a lack of knowledge of any
    such prosecution and stated that it would be “incredibly
    unlikely” that any such federal prosecution would ensue in the
    future. So, the court’s statement, ante at 3035, that
    “[a]lthough Raich has not suffered any past injury, she is
    faced with the threat that the Government will seize her medi-
    cal marijuana and prosecute her for violations of federal drug
    law” is plainly not supported by the record.
    Accordingly, I return to the issues of standing, ripeness and
    justiciability advanced in my earlier dissent in this case. With
    specific regard to the court’s lengthy discussion of and rulings
    upon the doctrine of common law necessity, it is clear that
    “[W]here it is impossible to know whether a party
    will ever be found to have violated a statute, or how,
    if such a violation is found, those charged with
    enforcing the statute will respond, any challenge to
    that statute is premature.” Alaska Airlines, Inc. v.
    City of Long Beach, 
    951 F.2d 977
    , 986 (9th Cir.
    1991). To satisfy Article III’s standing requirements,
    RAICH v. GONZALES                       3059
    a plaintiff must show that she has suffered a concrete
    and particularized injury in fact that is actual or
    imminent (not conjectural or hypothetical). Plaintiff
    must also show that the injury is fairly traceable to
    the challenged action of the defendant and that it is
    likely, as opposed to merely speculative, that the
    injury will be redressed by a favorable decision. Citi-
    zens for Better Forestry v. United States Dep’t of
    Agric., 
    341 F.3d 961
    , 969 (9th Cir. 2003).
    Raich v. Ashcroft, 
    352 F.3d 1222
    , 1235-36 (9th Cir. 2003)
    (Beam, J., dissenting).
    Here, as to Raich, there is no discrete, challenged action
    from which an injury can fairly be traced. San Diego County
    Gun Rights Committee v. Reno, 
    98 F.3d 1121
    , 1127 (9th Cir.
    1996), requires Raich to show a specific threat of prosecution,
    and she bears the burden of establishing that the statute in
    question is actually being enforced. A specific warning of
    prosecution may suffice, but “a general threat of prosecution
    is not enough to confer standing.” 
    Id.
     Accordingly, the appli-
    cability, or not, of the doctrine of common law necessity is
    not a justiciable issue on this record and Raich currently has
    no standing to ask the court to consider the matter.
    Assuming for purposes of discussion that the bare question
    of the viability of the doctrine is before us, I nonetheless
    respectfully disagree with substantial portions of the court’s
    analysis of the matter.
    The doctrine of common law (medical) necessity is an
    affirmative defense assertable only in a criminal prosecution.
    E.g., United States v. Arellano-Rivera, 
    244 F.3d 1119
    , 1125-
    26 (9th Cir. 2001) (holding that “before a defendant may pre-
    sent evidence of a necessity defense, his offer of proof must
    establish that a reasonable jury could” ascertain all the ele-
    ments of the defense) (emphasis added). After reference to
    several measures of potential injury and harm to Raich almost
    3060                      RAICH v. GONZALES
    totally unrelated to a reasonably foreseeable criminal prosecu-
    tion, the court ultimately recognizes the legal limitations of
    the defense, but only after issuing what amounts to a lengthy
    advisory opinion.
    Here we are engaged in the review of a civil proceeding
    seeking declaratory relief and injunction, not a criminal adju-
    dication. It is important to note that, contrary to the inference
    of the court in its factual dissertation, there has been no “testi-
    mony” in this case directly addressing the elements of this
    defense. The evidentiary record, such as it is, was developed
    in the district court through a request for a preliminary injunc-
    tion under Rule 65 of the Federal Rules of Civil Procedure.
    All facts recited by the court, some of which are admittedly
    testimonial in nature, arise from written “declarations” pro-
    vided by Raich, Monson, Dr. Lucido and Dr. Rose, Monson’s
    physician, in support of the injunction request. Yet, every case
    cited by the court concerning the viability of the doctrine and
    its elements involves a criminal prosecution.1 The burden of
    proof of such a defense lies with the defendant and involves
    the following elements:
    As a matter of law, a defendant must establish the
    existence of four elements to be entitled to a neces-
    sity defense: (1) that he was faced with a choice of
    evils and chose the lesser evil; (2) that he acted to
    prevent imminent harm; (3) that he reasonably antic-
    ipated a causal relation between his conduct and the
    harm to be avoided; and (4) that there were no other
    legal alternatives to violating the law.
    United States v. Aguilar, 
    883 F.2d 662
    , 693 (9th Cir. 1989).
    1
    See, e.g., United States v. Bailey, 
    444 U.S. 394
     (1980) (discussing the
    choice of two evils doctrine); United States v. Schoon, 
    971 F.2d 193
     (9th
    Cir. 1991) (giving the burning jail example); United States v. Aguilar, 
    883 F.2d 662
     (9th Cir. 1989) (explaining the standards and elements of the
    necessity defense).
    RAICH v. GONZALES                        3061
    In this civil action, Raich is not presently in a posture to
    address elements one, two and three and cannot establish ele-
    ment four. She has not been faced with a “choice of evils,”
    one of which could lead to a criminal prosecution. Nor has
    she acted to prevent “imminent harm.” She has presented no
    evidence of a tested, adversarial nature sufficient to establish
    the causal relationship required by element three. And, she
    has not established and probably cannot establish that she has
    no legal alternative to violating the law.
    The court states that “Raich’s physician [Dr. Frank Lucido]
    presented uncontroverted evidence that Raich ‘cannot be
    without cannabis as medicine’ because she would quickly
    suffer ‘precipitous medical deterioration’ and ‘could very
    well’ die.” Ante at 3039 (emphasis added). This opinion evi-
    dence is, of course, gleaned from a written declaration seek-
    ing declaratory and injunctive relief while positing a very
    speculative happenstance. The opinion is not the fruit of an
    adversarial hearing involving the assertion of an affirmative
    defense by a criminal defendant in a criminal prosecution
    designed to test the admissibility and credibility of the pro-
    posed evidence. But even if Raich “cannot be without canna-
    bis as medicine,” as Dr. Lucido opines, cannabis (or its
    synthetic equivalent) as medicine is lawfully available to
    Raich through the prescription-dispensed drug Marinol.2 And,
    newly crafted or presently existing drugs as yet untested by
    Raich may become known or available prior to any prosecu-
    tion. So Raich may well have a legal alternative to the viola-
    tion of the drug control laws.
    I also cannot fully join the court’s analysis of United States
    v. Oakland Cannabis Buyers’ Cooperative, 
    532 U.S. 483
    (2001), as set forth in its footnote 4. Ante at 3038. Although
    2
    The active ingredient in Marinol is synthetic delta-9-
    tetrahydrocannabinol, a naturally occurring component of Cannabis sativa
    L, the marijuana Raich says she now consumes. Physicians’ Desk Refer-
    ence, 61st ed., 2007 at 3333.
    3062                    RAICH v. GONZALES
    I do not concede that the Supreme Court’s discussion in Oak-
    land Cannabis is dicta, I do agree with the court’s conclusion
    that the case does not abolish “common law necessity juris-
    prudence.”
    Thus, while I do not concur in the court’s statement that
    “Raich appears to satisfy the threshold requirements for
    asserting a necessity defense under our case law,” ante at
    3039, I do acknowledge that she certainly may be eligible to
    advance such a defense to criminal liability in the context of
    an actual prosecution.
    Finally, if I fully understand the majority’s approach, the
    most troubling aspect of its opinion is that it purports to let
    this court determine, on the evidence presented to the district
    court at the Rule 65 hearing, that Raich, and anyone similarly
    situated, is entitled to a medical necessity defense if crimi-
    nally prosecuted in the future. I respectfully believe that this
    turns applicable federal criminal procedure on its head. The
    viability and applicability of this affirmative defense is a
    mixed question of law and fact. Arellano-Rivera, 
    244 F.3d at 1125
    . In a criminal prosecution of Raich for possession and
    use of marijuana for medicinal purposes, if it ever occurs, the
    issue of the sufficiency of the evidence to submit this particu-
    lar defense to a jury is a question of law for the federal trial
    court. 
    Id.
     The establishment of the factual elements of the
    defense, if submitted, is for the jury (or other trier of fact). 
    Id.
    Imposition of this court’s rulings into a later prosecution
    would improperly pretermit established criminal procedure.
    Thus, the court’s medical necessity discussion is a wholly
    speculative and possibly unconstitutional jurisprudential exer-
    cise.
    CONCLUSION
    Accordingly, for the above-stated reasons, I dissent from
    portions of the court’s factual findings and legal conclusions
    RAICH v. GONZALES                  3063
    but concur in the denial of Raich’s request for injunction and
    in the court’s affirmance of the district court.
    

Document Info

Docket Number: 03-15481

Filed Date: 3/13/2007

Precedential Status: Precedential

Modified Date: 10/14/2015

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