Both women have tried a variety of medications but say the side effects have only increased suffering. Their physicians recommended they try marijuana. A 1996 California law permits such use. But federal law bans marijuana as an illegal drug. The law says there is "no currently accepted medical use in treatment in the United States."
Federal drug agents and the US attorney general sought to prosecute Raich and Monson as criminals. Lawyers for the two argued that the federal law impermissibly infringed on California's authority to govern the health and well-being of its residents. Their marijuana was grown locally with local materials and at no time crossed state lines triggering commerce-clause authority, they said.
The majority justices disagreed. In his majority opinion, Justice John Paul Stevens says the federal government has the power to enact a total ban on marijuana use, even when locally grown and used.
Justice Stevens and the other majority justices saw the case as substantially similar to a landmark 1942 commerce-clause decision called Wickard v. Filburn, in which the high court upheld federal regulation of wheat production on a family farm even when the wheat was grown for home consumption.
"In both cases, the regulation is squarely within Congress' commerce power because production of the commodity meant for home consumption, be it wheat or marijuana, has a substantial effect on supply and demand in the national market for that commodity," Stevens writes.
"In assessing the scope of Congress' Commerce Clause authority, the court need not determine whether respondents' activities, taken in the aggregate, substantially affect interstate commerce in fact, but only whether a 'rational basis' exists for so concluding," he says.
"Congress had a rational basis for believing that failure to regulate the intrastate manufacture and possession of marijuana would leave a gaping hole in the CSA [Controlled Substances Act]," Stevens writes.
Joining Stevens' majority were Justices Anthony Kennedy, David Souter, Ruth Bader Ginsburg, and Stephen Breyer. Justice Antonin Scalia filed an opinion concurring in the judgment.