Joint Effort

"Aging hippies" team with the desperately ill and one lawmaker to fight for medical marijuana in Texas. Is that just a smoke screen?

The local sheriff was happy to oblige, telling the New York Times this was just a bunch of "old hippies going through a change of life." Ptak thought he missed the point. "Recreational use wasn't the issue," he says. "This was an educational campaign to inform the public that marijuana has medicinal and economic uses." (Meaning industrial hemp, a nonpsychoactive strain of marijuana used to make paper and other products.)

As punishment, Ptak received probation and a fine. Zeal Stefanoff, a medical marijuana user who had initiated the protest, was sentenced to six months in jail. He went on a hunger strike that lasted more than a month and stirred his sympathizers to camp out in front of the jail in what became known as Hemp Town. Ptak won High Times magazine's "Freedom Fighter of the Month Award" for his organizing efforts.

This dubious distinction didn't help his standing with local law enforcement types, who busted him again in 1996 for possessing "1.5 grams of marijuana," he says. Although there was no Texas statute on the books covering medical necessity, he pleaded that people have a common law right to medicate themselves as necessary. A jury acquitted him of all charges in what he believes is the first successful defense in Texas based on medical necessity.

George McMahon is one of eight medical marijuana patients who get their pot straight from the federal government. He is also an honorary member of the Oakland Cannabis Buyers' Cooperative, the California marijuana pharmacy that is being sued by the federal government for distributing pot to its card-carrying patients. (The co-op misspelled McMahon's name.)
Stephen P. Karlisch
George McMahon is one of eight medical marijuana patients who get their pot straight from the federal government. He is also an honorary member of the Oakland Cannabis Buyers' Cooperative, the California marijuana pharmacy that is being sued by the federal government for distributing pot to its card-carrying patients. (The co-op misspelled McMahon's name.)

Stefanoff wouldn't be so fortunate. Last year, as a defense to a marijuana charge, Stefanoff claimed he had been growing pot to alleviate the symptoms of the post-traumatic stress disorder he suffered in the Vietnam War. His psychiatrist as well as Robison testified on his behalf. However, Stefanoff was convicted, and his case is now on appeal. For medical marijuana activists, his conviction illustrated the need for the legislature to speak to the issue, rather than rely on common law precedent.

Patients in other states, however, were having more luck, particularly in California, which in 1996 passed Proposition 215, a vaguely worded initiative that called for lifting drug penalties on doctors who "recommend" marijuana and their patients who need it. Underground pharmacies, however, such as the Oakland Cannabis Buyers' Cooperative, had been supplying patients with marijuana illegally for several years. With Proposition 215, more cannabis clubs began sprouting up in California--though their legality remained in doubt.

Even after the passage of the California initiative, Clinton drug czar Gen. Barry McCaffrey was unwilling to give up the fight. Calling marijuana a "gateway" to harder drugs, he maintained, "there is not a shred of scientific evidence that shows that marijuana is useful or needed. This is not medical. It's a cruel hoax." To prove his point, he threatened to revoke the license and even arrest doctors who prescribed marijuana to their patients. He also commissioned a study by the Institute of Medicine, a division of the National Academy of Sciences, to settle the matter of marijuana's medical efficacy. After an 18-month investigation, a panel of 36 scientific experts issued a report in March 1999 that seemed to have something for everyone.

It found that marijuana was neither addictive nor a gateway drug and concluded that, "There are some limited circumstances in which we recommend smoking marijuana for medical uses"--primarily for the terminally ill, "who suffer from severe pain, nausea, and appetite loss."

The report did not call for the legalization of medical marijuana. Rather it recommended that clinical trials be allowed to study its safety and effectiveness. It indicated that the future of marijuana was not in its smoked form because users may face an increased risk of lung damage and cancer. What was needed instead was the development of "a nonsmoked rapid onset cannabinoid drug delivery system"--an inhaler or patch or suppository.

Some medical marijuana opponents feel that delivery system is already available in the form of the FDA-approved pill Marinol, which contains synthetic THC. But patients claim that Marinol takes too long to work, and when it does, it comes on too strong. With 60 different cannabinoids (including THC) in the marijuana plant, there may be some combination of elements that is causing whatever good patients derive from smoking it.

"Marijuana advocates have dismissed the most damaging conclusion in the report," Lt. Col. Maginnis says. "That marijuana's future as medicine does not require smoking. It's just bad medicine and bad policy...a red herring for those whose agenda is legalization."

Pharmacology professor Morgan finds the debate over delivery systems more about policy than medicine. "It's like the government is saying, 'You may take synthetic Vitamin C to prevent scurvy, but you may not drink orange juice because it's against the law.'"

With the medical debate raging, the legal battle wasn't far behind. In 1998, the California U.S. Attorney's Office sued the Oakland Cannabis Buyers' Cooperative and convinced a federal judge to order it closed, finding it violated the federal law prohibiting the sale and distribution of the drug. The cooperative raised the defense of medical necessity on the part of its members, and at one point, a federal appeals court agreed with its position. After all, patients who could legally possess pot under California law had to have some way of legally obtaining it. Not if it violates federal law, argued the government, which succeeded in convincing the Supreme Court to hear the case.

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