Pubdate: Sun, 25 Mar 2001 Source: Houston Chronicle (TX) Section: A, Pg 1 Website: http://www.chron.com/ Address: Viewpoints Editor, P.O. Box 4260 Houston, Texas 77210-4260 Email: http://www.chron.com/content/hcitalk/index.html Copyright: 2001 Houston Chronicle Fax: (713) 220-3575 Author: Patty Reinert POTFUL OF CONTROVERSY Supreme Court Weighs Drug Law - Medical Marijuana Puts States On The Front Line Of Federal War SAN FRANCISCO - It was Friday afternoon, his work was done, and Keith Vines had made his decision. The former Air Force captain turned prosecutor, who had prided himself on being a foot soldier in his country's war on drugs, was leaving his office and heading downtown to score some pot. "It was . . . awkward," he said, recalling the day in 1993 that he walked into a quasi-legal cannabis club holding a note from his doctor and walked out clutching a baggie of marijuana. Sitting on his couch last week, surrounded by paintings and photographs of family and friends, Vines, 50, said the choice he made was life-and-death. "Either try this medicine and save your life or waste away and die," he said. "I chose the first." Today, 4 1/2 years after California voters passed a referendum legalizing the cultivation and possession of marijuana for medical use, Vines pays a delivery service to bring the medicine to his door. He smokes when he has to, to stimulate his appetite to help digest up to 20 pills a day to combat AIDS and to stave off the wasting that previously pulled 50 pounds off his frame in just a few months. What he does is legal under California law but illegal under federal law. Vines, who worked as a felony drug prosecutor in the San Francisco district attorney's office, cringes at his reputation as "pot's poster boy." He is among thousands of desperately ill patients in California and elsewhere who believe they live today because their states legalized medical access to marijuana. The federal government's studies lend some credence to their claims, but prosecutors citing federal law and politicians fearful of appearing soft on drugs are determined to silence them. This week, the U.S. Supreme Court will make its first foray into the medical-marijuana debate, hearing arguments in a case the federal government filed in hopes of shutting down the Oakland Cannabis Cooperative and five other California marijuana distributors. At issue is whether patients and their suppliers can claim "medical necessity" to shield them from prosecution on federal drug charges. U.S. District Judge Charles Breyer, brother of Supreme Court Justice Stephen Breyer, originally sided with the government. But the 9th U.S. Circuit Court of Appeals overruled, forcing him to carve out a narrow exemption in the law for seriously ill patients who have exhausted other treatment options. The government appealed to the Supreme Court, which granted a stay of the 9th U.S. Circuit's decision pending the outcome of the case. Because of his brother's involvement, Stephen Breyer will not hear the case. A decision by the other eight justices, expected by July, could help determine whether federal drug laws should trump medical-marijuana laws passed in California and nine other states and contemplated in many more. On one side of the case are government lawyers and drug-war advocates who say state laws easing marijuana restrictions are based on faulty science and undermine the nation's fight against drug traffickers. They argue that smoking marijuana is dangerous and addictive, and that the real goal of the medical-marijuana movement is legalizing the drug for recreational use. On the other side are patients such as Vines, their doctors and those who risk going to prison to provide them with what they consider a safe and effective drug, as well as drug-war opponents who believe the government has spent too much money and effort on a losing battle. Some doctors have embraced marijuana to treat pain and nausea, a debilitating side effect of chemotherapy and other treatments for cancer and AIDS. Many also tout its benefits in treating glaucoma and in stimulating the appetite of people who find it difficult to eat enough. Spurred by research and patient testimonials, a growing number of state legislatures have attempted to pass "compassionate use" laws, allowing access to the drug on a doctor's recommendation. And where legislative efforts have failed, voters have forced the issue through referendum. Californians passed Proposition 215, the Compassionate Use Act, in 1996 after then-Gov. Pete Wilson twice vetoed medical-marijuana bills. Voters in Oregon, Alaska, Washington, Maine, Arizona, Nevada, Colorado, Arkansas and Washington, D.C., have jumped on board, and last year, Hawaii's state legislature became the first to pass a medical-marijuana law. Legislation is pending in many other states, including Texas, where lawmakers are considering a bill by Rep. Terry Keel, R-Austin, a former prosecutor. "If people suffering from cancer, epilepsy or MS are in pain and this could give them some relief, it's only appropriate that they should have a chance to talk about it with their doctors and allow their doctors to look seriously at how marijuana may help improve their health," said Shelton Green, Keel's legislative aide. Green said the bill has a realistic chance of passing the Texas House this session. But the inevitable end-of-session time crunch threatens to prevent its hearing in the Senate before the May 28 adjournment, putting the issue off until 2003. In California, the medical-marijuana movement has found unlikely spokesmen in Vines and Jeff Jones, a 26-year-old Christian conservative and native of South Dakota. Jones, who favors navy pinstriped suits and says he does not smoke marijuana, moved to California and opened the Oakland Cannabis Cooperative after watching his father die of kidney cancer. Jones has befriended police and city officials who have embraced his co-op as a city service provider. The back room of the co-op, across the street from Leo's Pharmacy and down the way from the Christian Science Reading Room in downtown Oakland, resembles a small driver's-license bureau where potential patients show letters from their doctors, fill out paperwork and pose for photos. Twenty-five dollars buys them a membership and an ID card that will help police distinguish them from recreational pot users. Until its recent legal troubles, the co-op distributed marijuana to more than 5,000 members. Now it offers classes to teach patients where to safely purchase the plant or how to grow their own. Out front in the hemp store, clerks instruct patients on the use of rolling papers and marijuana pipes as shoppers wander in from the street to browse through racks of hemp clothing, marijuana cookbooks, vegan hemp lip balm, sun catchers with pot-leaf motifs and "While you were out getting stoned . . . " message pads. Jones, whose database contains the names of more than 1,000 doctors who have recommended marijuana for their patients, said neither he nor they intended to break the law. "But I will keep doing this until they jail me," he said. "State law says we can do this. We just need a little bit of tolerance (in the federal law) so we can get this medicine to people who really need it. I am devastated that our government is so strung up on the political issue while people are suffering and dying." Under the 1970 federal Controlled Substances Act, drugs are classified on one of five "schedules." Congress has designated marijuana as Schedule I, the most restrictive category, indicating that it has a high potential for abuse, has no currently accepted medical use and is unsafe. No one may distribute a Schedule I drug except as part of a research project registered with the Drug Enforcement Administration and approved by the Food and Drug Administration. The federal government currently operates one such project, the Compassionate Investigative New Drug program, which has supplied marijuana to eight test patients for years. The results of that program prompted the DEA's chief administrative-law judge, Francis Young, to rule in 1988 that marijuana is "one of the safest therapeutically active substances known." Urging that marijuana be reclassified to Schedule II, the same as prescription painkillers like codeine or morphine, Young said it would be "unreasonable, arbitrary and capricious for DEA to continue to stand between those sufferers and the benefits of (marijuana)." Medical-marijuana proponents also point to a 1999 government-commissioned study by the Institute of Medicine, which concluded that marijuana can help ease pain and nausea, with few side effects. Federal prosecutors aren't impressed. U.S. Solicitor General Seth Waxman argues in his Supreme Court brief that any erosion of the law "significantly undermines the effectiveness of the CSA (Controlled Substances Act) and threatens the government's ability to enforce an Act of Congress that is central to combating illicit drug trafficking." President Bush, who says he is a strong advocate of states' rights, has remained quiet on the issue. But government lawyers and their supporters insist marijuana is not good medicine. David Evans, a New Jersey attorney who wrote a friend-of-the-court brief for Drug Free America's Institute on Global Drug Policy, argues that marijuana advocates should not be allowed to bypass a federal drug-approval process that has worked to keep patients safe for more than 100 years. "A referendum is good. It expresses the will of the people; it's democracy in action and all that stuff," he said. "But suppose a pharmaceutical company wanted to sell a drug like thalidomide," which was taken off the market after pregnant women taking the drug gave birth to severely deformed children. "What if, instead of going through our drug-approval process, they said, 'Let's go get some pregnant women and put them on TV, launch a multimillion-dollar ad campaign.' Suppose we set our medical approval process on that," Evans said. "Would you feel very confident if you went into a pharmacy to buy some medicine?" Evans and lawyers with the Family Research Council, which also filed a brief supporting the government, suggest that rather than smoking illegal marijuana, patients should try marinol, a pill available by prescription that is made from THC, the main active ingredient in marijuana. But many doctors and pharmaceutical researchers side with the patients, saying smoked marijuana, while it has its risks, is more effective than marinol, working faster and better and in many cases requiring a smaller dose. Vines tried marinol first but found that it left him feeling stoned or sleepy, preventing him from concentrating, while doing nothing to increase his appetite. "With just one or two puffs of smoked marijuana, I can eat," he said. "The effect is immediate, and I don't have the side effects. I'm not doing this for recreation. I'm doing it so I can stay alive." Vines points out that unlike aspirin, which is considered relatively benign and is available over the counter, marijuana is not known to have caused a single death by overdose. He contends that the latest research funded by the government indicates that the drug is not addictive. Nor is it any longer considered a "gateway" to serious drug abuse. Daniel Abrahamson, a California lawyer with the Lindesmith Center who filed a friend-of-the-court brief for the American Public Health Association in support of the cannabis clubs, calls the "slippery slope toward legalization" argument "simply absurd." "Morphine can be prescribed legally by a doctor, and nobody is arguing that that will lead to the legalization of heroin," he said. "We're talking about doctors who are trusted with some of the most dangerous medications in the world. They should also be trusted to recommend marijuana." - --- MAP posted-by: Beth