https://hightimes.com/
From the Archives: Mr. Randall Goes to Washington (1980)
By Robert Randall Once a week I go to a pharmacy located near my home in Washington, D.C., to pick up 70 prerolled cigarettes containing two and a half ounces of marijuana. The transaction is perfectly legal. My marijuana dealer is the U.S. government. I have glaucoma, a painless, incurable eye disease. Uncontrolled, it results in blindness. In 19731 accidentally discovered that smoking marijuana significantly reduces the eye pressure associated with my disease. Armed with the medical knowledge of a tenth-grade biology student, I conducted trial-and-error tests to determine if a drug I enjoyed using could prolong my sight. By the spring of 1974 the evidence was too persuasive to ignore and I added marijuana to my complement of conventionally prescribed antiglaucoma drugs. This illicit program of medication worked reasonably well. But marijuana purchased on the black market is always expensive, often unavailable and seldom of high quality. To offset these hazards I grew my own marijuana. In August 1975 I was arrested by the District of Columbia vice squad for cultivating four marijuana plants on a secondfloor sun deck. My first impulse was to plead guilty, pay a small fine for my indiscretion and return to my career as a college professor. But within a week of my arrest I learned the federal government also knew of marijuana’s potential value in the treatment of glaucoma. Several officials actually encouraged me to continue smoking cannabis on the sly. So I freely admitted smoking marijuana but pled not guilty for reasons of medical need. To support this claim I underwent 13 days of controlled medical study in December 1975 at the Jules Stein Eye Institute at the University of California at Los Angeles. I was hospitalized for six additional days of observation in March 1976 at the Wilmer Eye Institute, John Hopkins University. Ophthalmologists at the Stein and Wilmer institutes found I was suffering a “conventional medications failure,” and submitted the same prognosis: Unable to establish adequate control over my elevated eye pressures, I would suffer a rapid progression of sight loss ending in blindness. The physicians at Wilmer proposed surgical intervention as a last resort. The research ophthalmologists at UCLA, licensed to test marijuana, recommended cannabis therapy. In May 1976 I used this information to petition federal drug-abuse agencies requesting immediate, legal access to government stocks of marijuana for medical use. Robert Rosenthal, acting chief counsel for the Drug Enforcement Administration, rejected this appeal saying, “Mr. Randall is an individual and a criminal.” He did not indicate for which of these twin sins relief was denied me. After reconsideration, the Drug Enforcement Administration decided my petition was a medical request and bucked it to the Food and Drug Administration. FDA followed DEA’s example and forwarded my appeal to the National Institute on Drug Abuse. While my petition was being dispatched into bureaucratic oblivion I went on trial in Washington, D.C., in July 1976. The pur pose of the trial was to determine if I, as an individual, were indeed “criminal.” My personal physician, Dr. Ben Fine of Washington, testified he had no firsthand knowledge of marijuana’s potential benefits (such knowledge being illegal for him to possess). He could, however, relate the primary facts of my medical history. My glaucoma was beyond the control of conventional medications; surgery presented grave risks. He concluded by telling the court, “As a physician I believe it is in the best interest of the patient to pursue avenues of possible pressure control, if they are effective, regardless of their conventionality.” Dr. Robert Hepler, then the nation’s only ophthalmologist licensed to investigate marijuana’s effect on the eye, went further. “Without marijuana he will go blind,” he told the court. “With marijuana his sight might be saved.” The U.S. attorney prosecuting me did not question the medical fact marijuana might save my sight. Nor did he bother to offer any concrete evidence to show marijuana was not safe. Instead, he.alleged marijuana could cause “(Mr. Randall’s] legs to fall off,” then added the evidence was irrelevant because there is “no constitutional right to eyesight.” After four months of deliberation Judge James Washington, Jr., ruled my use of marijuana was not criminal, but a consequence of medical “necessity” protected by law. The court declared in part, “While blindness was shown by competent medical testimony to be the otherwise inevitable result of defendant’s disease, no adverse effects from the smoking of marijuana has been demonstrated…[It] is doubtful,” the court reasoned, “that [marijuana’s] slight, speculative and undemonstrable harm could be considered more important than defendant’s right to sight.” It was the first successful case of medical “necessity” ever brought in an American court and only the 13th successful defense of necessity (a rare legal doctrine) in the 750-year history of English common law. Judge Washington’s verdict also marked the first time in 40 years that any branch of the federal government acknowledged marijuana to be a therapeutic agent. Within the month federal drug abuse agencies answered my petition by granting me legal access to government stocks of quality-controlled cannabis. I became America’s first and only legal marijuana smoker in November 1976. I smoked legal marijuana for Walter Cronkite and Tom Snyder and appeared on “To Tell the Truth.” Midnight magazine headlined, BOB SMOKES POT-AND IT’S LEGAL. The Washington Post wondered why “a man losing his sight has to rely on the courts to get the right to smoke marijuana to stave off total blindness.” Dorothy Storck, a columnist for the Philadelphia Inquirer, wrote, “One has the feeling the marijuana millennium is near.” Muckraker Jack Anderson paused between scandals to declare me “America’s most famous pot smoker,” a dubious distinction at best. I did not mind being the free world’s first legal pot smoker, but I deeply resented being the only American with medical access to marijuana. It left me feeling much like the man who makes the lifeboat and then finds he is alone. Four million Americans have glaucoma, a disease that is this nation’s second leading cause of blindness. According to the National Eye Institute 10 percent—or 400,000—of these glaucoma patients are unresponsive to conventional medications. But the question of marijuana’s medicinal use extends beyond glaucoma. Historical records and modern clinical data indicate there is a wide range of maladies that may be responsive to cannabis-based therapies. The most significant of these potentially beneficial applications for cannabis he in the plant’s ability to lower the elevated eye pressures associated with glaucoma, to reduce the nausea and vomiting generated by cancer chemotherapies and radiation treatments, and to lessen the spasticity endemic to certain types of multiple sclerosis and other neural and muscular disorders resulting in convulsion. Many patients afflicted with glaucoma, cancer and multiple sclerosis are now demanding legal access to marijuana. Growing numbers of their physicians, medical researchers and health-care professionals are also calling for marijuana’s release for medical applications, and the general public, media and politicians are increasingly supporting extensive reform measures. Recently, the National Center for Telephone Research of Pennsylvania and respected Nebraska pollster Joe B. Wilhams, found that 83 percent of the registered voters in both states approved of marijuana’s medicinal use. Farmers and ranchers in rural Nebraska were the least enthusiastic group surveyed, but by a sizable 69 percent they also supported legalizing access to cannabis for patients and physicians. On January 26, 1979, American Medical News, an American Medical Association sponsored publication distributed to physicians and health-care professionals, reported that, almost unnoticed, the question of marijuana’s legalization for therapeutic applications “is becoming one of the top medical issues this year.” The public demand for reform, while subtly expressed, has sparked a dramatic political response. In 1978, four states (New Mexico, Florida, Louisiana and Illinois) abandoned federal models of prohibition to enact laws permitting marijuana’s medical use by glaucoma and cancer patients confronting “life and sense-threatening” disability. The tempo of reform has accelerated. Fifteen additional states—Alabama, California, Colorado, Georgia, Iowa, Maine, Michigan, Nevada, North Carolina, Ohio, Oregon, Texas, Virginia, Washington and West Virginia—have enacted similar laws. Approximately 15 more states are considering measures to release marijuana for medical purposes before the end of the 1979-80 legislative session. While this mushrooming political activity is impressive, the depth of legislative support commanded by these reform actions is more instructive. The Louisiana State Senate voted 34-4 to release marijuana for medical use. In Oregon both houses of the state legislature gave unanimous consent. The conservative Florida House of Representatives approved that state’s new law by a resounding 96-6. Illinois governor James Thompson signed his state’s bill into law by calling the measure “a step forward in the practice of medicine.” Despite these innovative state laws, I still remain one of a handful of individuals with legal access to cannabis. But from my protected niche of privilege I have watched other individuals, denied similar care, suffer needlessly and go blind. Ara Cron of Wichita, Kansas, is 65, retired and suffers from glaucoma. Like many who wrote to me, Mrs. Cron wanted to know if marijuana could prolong her vision. Ara feared surgery and not without good cause. Her father had glaucoma and was blinded by ocular surgery. I could not answer her question, but instead provided her with the available research data, some general information on marijuana and the names of various federal officials. Over the next several months Mrs. Cron and her doctor contacted these officials in an effort to secure legal access to marijuana. They failed, but as a result of her efforts she attracted local press attention. Shortly after articles appeared detailing her plight she found an ounce of marijuana, a pack of cigarette rolling papers, and instructions on how to roll a joint in her mailbox. That evening Mrs. Cron’s husband, Gerald, a retired Wichita high-school principal, measured his wife’s eye pressure as he had done nightly for six years. Then Ara Cron smoked marijuana for the first time in her life. An hour later Gerald rechecked his wife’s eye pressures and found marijuana had dramatically reduced her ocular tensions. In Mrs. Cron’s case, as in mine, the reduction was significant enough to lower her pressures into the “safe” range. In the following days Mrs. Cron’s ophthalmologist conducted several informal tests and reached the same conclusion. With access to adequate supplies of quality-controlled cannabis he felt surgery might be avoided. Both he and the Crons recontacted the Food and Drug Administration, the Drug Enforcement Administration and other federal agencies to request legal supplies of marijuana. The Crons also wrote to their federal and state legislators and the Carter White House seeking assistance. They received kind responses but found no help. Within several weeks the mailbox marijuana was gone and Mrs. Cron’s eye pressure became uncontrollably elevated. Unwilling to break the law, frightened of the illegal black market, the Crons waited until they could wait no longer. By June, Mrs. Cron was forced to resort to surgery. Technically, the operation was a success. But as a consequence of surgery Ara Cron, like her father, lost most of her remaining sight. “I’m very resentful,” she told UPI months later. “There are days now I can no longer read.” The Crons do not understand why no one moved to help them. “My doctor was more than willing to treat me with marijuana in the hope surgery could be avoided or at least postponed,” Mrs. Cron explains. She sighs. “The lack of a reasonable response to his and my repeated requests for legal access to marijuana has, I feel, cost me my sight.” Ara was the first glaucoma victim I watched go blind. She has not been the last. Victims of other diseases for which marijuana offers relief have fared no better. Lynn Pierson was 25 years old and dying of cancer when I met him in December 1977. He was a tall young man who looked old beyond his years. He was bone thin and completely bald as a result of chemotherapy. The medical philosophy behind chemotherapy is both simple and savage. A patient is larger than his disease, the theory goes, so if you begin killing the patient at a cellular level, his cancer will die before he does. Chemotherapeutic agents are brutal drugs that hold out the promise of prolonged life but subject patients to violent, nearly lethal side effects. After receiving chemotherapy some cancer patients collapse or go into convulsive shock. Most suffer devastating attacks of nausea and vomit for hours or days. In some instances the trauma is so intense patients begin to vomit as soon as they enter the hospital. Lynn Pierson, like many cancer patients, received chemotherapy once, then considered abandoning the treatments, preferring death to the debilitating consequences of the cure. Fearing Lynn would abandon further treatment, his oncologist suggested he smoke marijuana to reduce the nausea and vomiting. Lynn tried marijuana, it worked, and he continued receiving his anticancer injections. “After Lynn discovered smoking marijuana made chemotherapy tolerable,” his wife Cindy explains, “he tried to get one man, a close friend, to smoke with him. The man was twice Lynn’s age and chemotherapy was killing him. But he refused to smoke marijuana, not because he doubted it worked but because it was illegal. When that man died there was just no stopping Lynn.” Pierson approached the New Mexico legislature and asked for help. His appeal received broad public support, was backed by the state’s major media, and endorsed by the New Mexico Medical Society, which called for reform. In February 1978 New Mexico adopted the nation’s first law permitting marijuana’s medical use. But repeated efforts by the state to secure “legal” marijuana from federal drug-abuse agencies proved futile. Seven months after the law’s enactment Lynn Pierson died before smoking his first legal joint or benefiting from the legislation inspired by his efforts. He was not alone. By October 1978 Dr. George Goldstein, New Mexico’s secretary for health, bluntly informed Joseph Califano, at that time secretary of the federal Department of Health, Education and Welfare, that “every patient certified by the state as eligible to receive marijuana has died before receiving the relief promised.” Goldstein put Califano on notice that “further delays on the part of FDA are neither morally nor ethically defensible.” In a Health Department report issued in January 1979 New Mexico’s chief of substance abuse, Dr. Edward Deaux, complained that “it was definitely the intent of the [state law] to establish a program through which glaucoma patients and cancer chemotherapy patients could receive marijuana. Not to establish a program to deceive these patients into believing that they were receiving marijuana when, for the purposes of satisfying federal requirements, many were not.” Upon receiving the report, the New Mexico legislature reaffirmed the state’s decision to create legal, medical channels of access to marijuana and renamed the law in honor of Lynn Pierson. While public attention is beginning to focus on the question of marijuana’s use in the treatment of glaucoma and as an adjunct to chemotherapy, patients with less dramatic but equally sinister maladies are also unable to obtain relief. Meredith S. is a stunningly beautiful young woman who appears vital and filled with life. But like a million other Americans Meredith is afflicted with the spasticity that is frequently the result of multiple sclerosis. Like glaucoma and cancer, multiple sclerosis is incurable and the available medical treatments are limited. Multiple sclerosis disrupts nerve tissue and impairs the transmission of messages to and from the brain. It eventually cripples an individual by inflicting accumulative damage to the nerves. Introduced to Meredith through a mutual friend, I was skeptical when she told me she smoked marijuana to calm the spasticity caused by her disease. “Without marijuana I was in and out of the hospital every six months, growing weaker with each attack,” she said. “But if I smoke marijuana when I feel an attack coming on, I’m able to relax until it subsides.” Current therapies for multiple sclerosis involve the use of sedating, tranquilizing and narcotic substances, many of which are highly addictive and impair a patient’s ability to function normally. Meredith’s physicians knew she smoked marijuana and did not object. “Since I started smoking marijuana,” she told me, “I’ve learned to ski. Two or three nights a week I go dancing. Those are things I never thought I’d be able to do.” Marijuana was once prescribed as an antispasmodic, but there was no modern data on the subject when I spoke to Meredith in early 1977. Yet within a month of speaking with Meredith, I received letters from three other multiple sclerosis patients who made precisely the same claims. After months of appealing to the government for help Meredith found it easier to buy marijuana illegally. Early in 1979 the first study evaluating marijuana’s utility in the treatment of multiple sclerosis was published. Seven out of nine patients given marijuana experienced a reduction in spasticity. Dr. Tod Mikuriya, one of the nation’s pioneers in the field of marijuana research, is one of the most articulate critics of present policies. In Marijuana Medical Papers, a book devoted to cannabis’s therapeutic use, published in 1973, Mikuriya charged, “Medicine in the Western World has forgotten almost all it once knew about the therapeutic properties of cannabis. The treatment of a disease is far more important than the irrational prohibitory law which forbids marijuana’s medical use.” In Mikuriya’s mind, our present problems stem from “the illegitimate removal of cannabis from medical use in 1937, and a continuing attempt by federal agencies to rewrite history by seeking to create the impression marijuana is a ‘new’ drug.” Until the introduction of morphine, marijuana was the major painkilling drug used by the Union soldiers during the Civil War. Marijuana was available by prescription in this country for nearly a century. Between 1850 and 1940, several hundred articles extolling cannabis’s healing properties appeared in reputable medical journals. As late as 1924, the Merck Manual, a popular health guide, advised the use of marijuana for conditions including “eyestrain, nausea, vomiting, digestive distress and convulsive disorders.” During this same period almost no public concern was expressed about recreational use. The Reader’s Guide to Periodical Literature, a fair measure of cultural concerns, lists no articles on cannabis between 1917 and June 1935. In 1937, however, the Federal Bureau of Narcotics encouraged Congress to enact a prohibition against marijuana’s social use. Coincidentally, Harry Anslinger, the bureau’s director, published a book titled Marijuana: The Füller Weed. Borrowing from the popular detective fiction of this period, Anslinger’s book was laced with descriptive gore ranging from rape to murder. And it was effective. The Reader’s Guide to Periodical Literature for 1937-1939 boasts more than a dozen articles condemning marijuana’s social use. This sudden, well-cultivated surge in public concern over marijuana’s potential, if unproven harms galvanized Congress. Legislation outlawing the drug’s use was drafted. The only organized resistance against the prohibition came from the medical profession. Dr. William Woodward, a lawyer-physician and the American Medical Association’s Washington lobbyist, strongly opposed legislative action. In testimony before Congress, Woodward raised two objections to the proposed prohibition. First, he argued, marijuana was not dangerous enough to warrant legal sanctions against its social use. Second, and more particular to his professional interests, Woodward told Congress that efforts to enforce a social prohibition would result in a federal regulatory scheme that would interfere with marijuana’s legitimate use and thwart scientific study into the plant’s beneficial applications. “In all you have heard thus far,” Woodward said, “no mention has been made of any excessive use of the drug by any doctor or of its excessive distribution by any pharmacist…To say, however, as has been proposed here, that the use of the drug should be prevented by a prohibitive tax, loses sight of the fact that there are substantial medical uses for cannabis.” Congress dismissed Woodward’s medical judgment and passed the Marijuana Tax Act of 1937. Though the act did not specifically prohibit marijuana’s medical use, Woodward’s fears were quickly realized. By 1938, the Federal Bureau of Narcotics had promulgated 60 pages of additional regulations covering marijuana’s use in medicine. Ostensibly, these regulations sought to discourage the diversion of medicinal cannabis into social uses. Whatever the rationale, these federally imposed controls abruptly ended marijuana’s medical use in America. Major pharmaceutical companies, including Upjohn, Eli Lilly and Sharp & Dome, abandoned promising research programs. By 1941, marijuana and 28 cannabis-based extracts were dropped from the Pharmacopoeia of the United States (a list of available medicants) after a century of accepted medical use. With the medical profession effectively neutralized, the Federal Bureau of Narcotics, a police agency of the Treasury Department, assumed absolute control of all cannabis-related study. Between 1937 and 1967 the only extensive, long-term studies of marijuana conducted in the United States were undertaken by U.S. intelligence agencies, notably the Office of Strategic Studies (OSS) and the Central Intelligence Agency, in their search for a mind-control drug. This valuable store of data on marijuana and specially prepared cannabis extracts was destroyed in 1973 when retiring CIA director Richard Helms ordered all mindcontrol files shredded. Of course, the federal government’s ironclad control over marijuana’s availability for medical study did nothing to discourage the drug’s social use. By the mid 1960s, millions of white, middle-class youths were turning on. Citing these patterns of accelerating social use, Pres. Richard Nixon called for an even more comprehensive system of federal controls. His vehicle was the Uniform Controlled Dangerous Substances Act, drafted in 1970, a year after the Supreme Court ruled the Marijuana Tax Act of 1937 was unconstitutional because it was based on double jeopardy. The Controlled Substances Act creates five distinct classes or schedules of regulation. Marijuana was placed on Schedule I, the most restrictive classification possible, along with drugs such as heroin and LSD-25. Schedule I substances, legally defined as “without accepted medical value,’’ are said to have a “high potential for abuse.” As such, the medical use of Schedule I drugs is forbidden. Research on cannabis is possible, but only after such study has been subjected to review and approval by federal drug-abuse agencies. The Drug Enforcement Administration, a progeny of the Federal Bureau of Narcotics and a police agency of the Department of Justice, administers the Controlled Substances Act. The FDA has the authority to determine a drug’s classification and the DEA enforces the determination through the power of arrest. Charged with regulating the security that surrounds Schedule I substances, the DEA can veto any program of cannabis study it deems “inappropriate.” To make marijuana available for officially sanctioned research while respecting Schedule I prohibitions against the plant’s therapeutic use, the FDA has declared marijuana a new drug. As a new drug marijuana is regulated under the Food, Drug and Cosmetics Act and researchers must comply with the agency’s complex Investigational New Drug (IND) procedures. Through the IND process, the FDA has the power to accept or reject, advance, delay, adjust or amend any proposed program of study involving marijuana. A third federal agency, the National Institute on Drug Abuse (NIDA), enjoys an exclusive monopoly over the legal cultivation of marijuana in the United States. NIDA functions as the federal government’s marijuana drugstore, and manages federal funds available for the study of drug abuse. By exercising its dual authority over marijuana supplies and research funds, NIDA has a direct influence on the design and direction of marijuana’s evaluation. Thus, to obtain access to federal stocks of cannabis, a licensed physician (or a state] must request and receive supplies of marijuana from NIDA, comply with FDA procedures and satisfy DEA Schedule I security requirements. In the past decade the federal government has spent more than $40 million on marijuana-related research. Yet less than $1 million has gone into the exploration of the potentially beneficial applications of cannabis. The vast bulk of funds and research has gone instead into a deliberate effort to scientifically and medically demonstrate that marijuana is a drug of abuse. Under the Food, Drug and Cosmetics Act, only two essential criteria qualify a substance as a medicine: First, it must be “safe” relative to the disease being treated; second, it must be “effective” in providing patients relief. Since 1970 federal drug-abuse agencies have been aware of marijuana’s potential use in the treatment of glaucoma. In that year researchers at UCLA accidentally discovered that cannabis lowered eye pressure. By September 1971 Dr. Robert Hepler communicated an outline of the UCLA findings to the Journal of the American Medical Association. Hepler wrote, “The purpose of this letter is to present preliminary data concerning the most impressive changes observed so far, namely, a substantial decrease in intraocular pressure [following the use of marijuana]. The possible implications,” he stressed, “including … therapeutic action in the treatment of glaucoma are obvious.” While Hepler continued his work without funds, other short-term studies, some unauthorized, rechecked his findings and reached the same conclusion. By 1975 Hepler informed NIDA that “marijuana produces a consistent, dose-related, clinically significant reduction in intraocular pressure.” University of Georgia at Athens researcher Dr. Keith Green, approaching the question from a different perspective, reached the same conclusion. In 1976 Green told reporters, “Marijuana is as good as, if not better than, any existing glaucoma-control drug.” The federal response to these important medical discoveries was nonexistent. Even my court victory demonstrating marijuana’s potential value in the treatment of glaucoma in 1976 failed to ignite interest. NIDA, for example, funded no glaucoma-related research in 1976, 1977 or 1978. In late 1978, the National Eye Institution (NEI) publicly announced it would fund study in this area. At present NEI tells reporters there are five federally approved programs of study. NEI fails to point out that none of these programs is funded and that three are in various stages of suspension. My private program of medical care and a second single patient constitute the remaining two studies reported by NEI. Thus, a decade after Dr. Robert Hepler discovered the link between cannabis and reduced intraocular pressure, only two glaucoma patients in the United States are legally receiving marijuana. This same pattern of neglect toward marijuana’s medical use is not confined to glaucoma, but extends across a wide range of inquiry. Dr. Norman Zinberg and Dr. Stephen Sallan, of Harvard University and the Sidney Fabrer Cancer Center respectively, became intrigued when cancer patients who smoked marijuana reported less nausea and vomiting following chemotherapy. Working without funds they clinically analyzed these “anecdotal accounts” and found marijuana was an effective antiemetic. Moreover, Zinberg and Sallan learned what to most social marijuana smokers is obvious: Marijuana stimulates the appetite. Cancer patients who smoked marijuana got the “munchies,” ate well and maintained their weight during chemotherapy. By 1975, Zinberg and Sallan reported their findings to the New England Journal of Medicine. Sallan, who has continued his research, says, “To have less anxiety, little vomiting and a better appetite takes care of many of the toxic side effects of chemotherapy.” Ann Guttentag, a 53-year-old Pennsylvania cancer patient, agrees. “Without marijuana I doubt I would have made it this far.” Mrs. Guttentag calls Compazine, the antiemetic her physician prescribed, “a real dud. It made me feel dopey and didn’t work. I would vomit for hours. But with marijuana I just take a few puffs and the nausea and vomiting goes away. My appetite returns and I raid the refrigerator.” With the help of her doctor Mrs. Guttentag is now seeking federal permission to smoke marijuana legally. “I just don’t like getting my medicine off the streets,” she says. Physicians whose patients smoke marijuana face a compromising dilemma. A Washington, D.C, oncologist who asked not to be identified laments, “What am I supposed to do? Call the cops? Tell my patients to stop smoking? Not when the patients know marijuana works and they know that I know it works. I tell them to keep puffing. I’m a doctor, not a policeman.” With all the evidence, both clinical and anecdotal, from cancer and glaucoma patients and their physicians demonstrating marijuana’s medical value, why is cannabis being denied to those who might benefit? The Drug Enforcement Administration argues it is a police agency, not a medical clearinghouse. The Food and Drug Administration describes its role as “passive” and notes it has no funds to pursue marijuana’s medical use. The National Institute on Drug Abuse says its responsibilities are limited to evaluating a drug’s “abuse potential,” not its therapeutic value. Dr. Sidney Cohen, a longtime investigator of illicit drugs, told Psychology Today in 1978, “It is not necessary to be a masochist to study marijuana, but it certainly helps.” Cohen then Used 11 federal and state agencies involved in certifying, licensing, supplying and approving his marijuana-related research. Another physician familiar with this intimidating, multibureaucratic system of controls came away with “a gut feeling the federal government does not want anything positive to come out on marijuana.” This same system of regulatory disincentives is now being deployed against those states that have legalized marijuana’s therapeutic use. Last December, Barbara Weiner, an official of the Illinois Dangerous Drug Commission, complained, “The federal government is speaking with so many different, often conflicting voices, it is nearly impossible for the states to divine an appropriate remedy.” Even if the states penetrate these regulatory barriers, their efforts may prove futile. Since 1976 the quality and quantity of federal supplies of marijuana have declined dramatically. Indeed, NIDA has so mismanaged the nation’s only legal marijuana drugstore that the federal cupboard is bare. By conservative estimate 1.5 to 2 million glaucoma and cancer patients reside in the 20 states that have already recognized marijuana’s medical value. Even under the most restrictive programs of access, 150,000 to 400,000 individuals are legally qualified to receive access to marijuana. Yet in the face of rapidly accelerating demands and despite dire warning of an impending supply crisis, NIDA actually reduced the size of the 1979 crop to a mere three acres. Federal officials continue to reassure the states that supplies are adequate to meet “any conceivable need.” But by mid 1979 the supply shortage was so acute that Dr. Seymor Perry, chairman of a Carter-appointed interagency committee, admitted that NIDA could meet the medical needs of fewer than 250 individuals. NIDA is now offering the states a consolation prize: a synthetic marijuana substitute called delta-9 THC. Despite the fact that THC is more psychoactive than real marijuana and medically inferior in terms of the relief it provides, NIDA is aggressively pushing THC. A “pot pill,” even if ineffective, is more bureaucratically pleasing than having to admit that real marijuana has real medical value. Several states, sensing these trends, have sought to avoid the red-tape runaround. If NIDA fails to make good on its promise of adequate supplies both Iowa and Michigan have threatened to use confiscated (state-owned) marijuana. Oregon may abandon federal control completely and establish an intrastate program of cultivation and distribution. Washington will not look kindly on such innovative approaches. Control over supplies of marijuana is the last means by which federal agencies can manipulate the issue and the legality of intrastate solutions is uncertain. Indeed, only one thing seems certain: Patients, promised medical access to marijuana under state laws, are being deprived of marijuana by an entrenched federal bureaucracy terrified by the prospects of change. Unable to obtain marijuana legally, seriously ill patients are resorting to the illegal, unregulated black market for relief. According to American Medical News, “thousands—and perhaps tens of thousands—of glaucoma and cancer patients across the country” are medicating themselves with marijuana. As bureaucrats bicker and interagency committees meet patients, physicians and health-care professionals are stumbling through a legal no-man’s-land, making do with what is available. Should marijuana be released for medical applications? To thousands of patients, their families and physicians, this is like asking if the pope is Polish. The federal government may pretend marijuana is as mysterious as the planet Mars, but marijuana’s ability to reduce intraocular pressure, reduce the nausea and vomiting associated with chemotherapy, and control the spasticity generated by certain types of multiple sclerosis is obvious to many patients without a day of medical training. As long as the federal government retards research it can inversely argue there is not enough data to reach a conclusion. As long as “anecdotal accounts” are greeted with the same neglect given “folk medicine” (that vast 5,000-year period immediately preceding the Marijuana Tax Act in 1937), the prohibition will remain in force. Two generations—four decades—of Americans have already suffered unnecessary pain or blindness due to federal interference in marijuana’s medical evaluation. Perhaps it is time to consider a fresh approach. The state laws now being enacted beckon toward a more reasonable and responsible policy. But these actions will remain unfulfilled gestures until substantive reform occurs in Washington and in the philosophies of abuse that dominate bureaucratic interests. Until congressional action revamps existing policies, bureaucratic assumptions centering on marijuana’s social use will continue to condemn seriously ill citizens to a choice between unnecessary physical injury and violating the law. This choice, really no choice at all, has been made. Patients are smoking marijuana. The only question is When will they be allowed to buy medication in pharmacies instead of on the streets?
