Pubdate: March 21, 1999
Source: Orange County Register (CA)
Copyright: 1999 The Orange County Register
Section: News page 39
Author: Sheryl Gay Stolberg-The New York Times


Drugs: The federal 'compassionate use' program won't expand soon despite a
study showing marijuana can be therapeutic.

Every weekday around 11 a.m., a middle-aged stockbroker named his desk
and walks to a breezeway outside his office in Boca Raton, Fla. There,
alongside the potted palms and smokers taking their breaks, he lights
up a cigarette of his own - not tobacco, but marijuana, sent to him by
the federal government.

The arrangement is 16 years old and perfectly legal. Rosenfeld, who
suffers from a rare bone disorder and smokes to relieve his pain, is
part of an exclusive club of Americans who receive a free can of
marijuana cigarettes each month under a "compassionate use" program
sanctioned by the Food and Drug Administration and the National
Institute on Drug Abuse.

There are only eight participants in the program. "I'm one of the
fortunate people,"  Rosenfeld said.

Or at least, blessed with good timing. Since 1992 the door has been
shut on the little-know program, which began in 1978 and at its height
had no more than about 20 patients. Now, however, the question of
whether the government should be providing an illegal drug to a chosen
few has been thrust into the spotlight by a new study showing that
marijuana is beneficial for certain conditions, including pain, nausea
and the severe weight loss associated with AIDS.

The study, the most comprehensive review of the literature about
medical marijuana to date, was commissioned by the White House and
conducted by a committee of 11 scientists appointed by the Institute
of Medicine, a branch of the National Academy of Sciences. A report on
the study concluded that the benefits of smoking marijuana were
limited by the toxic effects of the smoke, but nonetheless recommended
that the drug be given under close supervision to patients who do not
respond to other therapies.

Yet, it does not appear likely that the list of government-approved
marijuana smokers will grow any time soon. Indeed, that the program
continues to exist at all is testimony to the government's
schizophrenic approach to one of the thorniest questions in law and
medicine: whether doctors should be able to write prescriptions for

On the one hand, the National Institute on Drug Abuse pays the
University of Mississippi to grow what a spokeswoman called a
"consistent, reliable source of research-grade cannabis" for Rosenfeld
and the seven other patients. A North Carolina manufacturing plant
receives $62,000 a year from the government to roll the cigarettes and
ship them in sealed tins of 300 each, to the patients' doctors and

Rosenfeld, 46, carries a folded-up letter in his wallet, dated March
17, 1983, from the Food and Drug Administration, authorizing him to
use a substance that might otherwise bring a federal prison term of up
to five years. Most days, he smokes in his car while driving to work;
"I get no euphoric effect," he said. The FDA letter, he added, has
been helpful on those rare occasions that the police have pulled him

On the other hand, Congress has prevented the District of Columbia
from releasing the results of a recent ballot question that asked
voters to decide if marijuana should be made legal for medical
purposes. And the Clinton administration has moved to shut down
marijuana buyers' clubs in California and has threatened to prosecute
doctors who write prescriptions for the drug.

"Why allow eight patients to have legal access to marijuana but
criminalize thousands of other patients in very similar circumstances
who have the same conditions, virtually identical medical histories?"
asked Chuck Thomas, spokesman for the Marijuana Policy Project, a
nonprofit group in Washington, D.C., that lobbies to make the drug
legal for medical use. "Why deny them legal access?"

That question is now before a federal judge in Philadelphia, where 165
patients have filed a lawsuit seeking to force the FDA to grant wider
access to the drug. The case is scheduled for trial in June.

"The compassionate access program is an acknowledgment by the
government of the United States that marijuana has medicinal value,"
said Lawrence Hirsch, the lawyer for the patients. "It is
fundamentally unfair for the government to supply marijuana for
medical necessity to eight people in the United States, when the rest
of the potential candidates for therapeutic cannabis are excluded."

In response, the Department of Justice argues that the government is
simply upholding the law. Congress has made the possession and
distribution of marijuana illegal, a spokesman for the department
said, and the FDA has no obligation to make exceptions to the law for
anyone other than those who had legal access to marijuana before the
legislation was enacted. 
- ---
MAP posted-by: Derek Rea